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60th  Congress  1  SENATE  I  Document 

Sd  Session      j  \   No.  644 


y/^  i  y 


REPORTS  OF  THE 

PRESIDENT'S  HOMES  COMMISSION 


MESSAGE  FROM  THE  PRESIDENT  OF  THE 
UNITED  STATES,  TRANSMITTING  RE- 
PORTS BY  THE  PRESIDENT'S  HOMES  COM- 
MISSION ON  IMPROVEMENT  OF  EXISTING 
HOUSES,  AND  ELIMINATION  OF  INSANI- 
TARY AND  ALLEY  HOUSES,  ON  SOCIAL 
BETTERMENT,  AND  ON  BUILDING  REGU- 
LATIONS, TOGETHER  WITH  RESOLUTIONS 
AND  RECOMMENDATIONS  ADOPTED  BY 
THE  COMMISSION 


if 

\      P 


January  8,  1909. — Read;  referred  to  the  Committee  on  the  District 
of  Columbia  and  ordered  to  be  printed  with  illustrations 


WASHINGTON 

GOVERNMENT  PRINTING  OFFICE 

1909 


,   '  CITY  AND  RE^' 

PLANNliNiG 
THE  PRESIDENT'S  HOMES  COMMISSION. 

(Appointed  by  President  Theodore  Roosevelt.) 


Gen.  Geo.  M.  Sternberg,  U.  S.  Army,  President, 

Geo.  M.  Kobeb,  Secretary. 

John  B.  Sleman,  Jr.,  Treasurer. 


Wm.  H.  Baldwin. 
Frederick  L.  Siddons. 
Prof.  Geo.  W.  Cook.  • 
Whitefield  AIcKinlay. 
Miss  Mabel  T.  Boardman. 
Mrs.  Thomas  T.  Gaff. 


James  Bronson  Reynolds, 
S.  W.  Woodward. 
T.  C.  Parsons. 
Emmett  L.  Adams. 
P.  J.  Brennan. 
Wm.  F.  Downey. 


EXECUTIVE    COMMITTEE. 

Geo.  M.  Sternberg,  Chairman. 


Geo.  M.  Kober. 
Wm.  H.  Baldwin. 
Frederick  L.  Siddons. 


S.  W.  Woodward. 

Miss  Mabel  T.  Boardman, 


T.  C.  Parsons. 
Geo.  W.  Cook. 
P.  J.  Brennan. 


committee  on  building  of  model  houses. 
Geo.  M.  Sternberg,  Chairman. 


Whitefield  McKinlay. 

John  B.  Sleman,  jr. 

Miss  Mabel  T.  Boardman. 


committee  on  improvement  of  existing  houses  and  elimination  of  insani- 
tary AND  alley   houses. 


S.  W.  Woodward. 
T.  C.  Parsons. 
Geo.  W.  Ck)ok. 


James  B.  Reynolds. 
Wm.  F.  Downey. 
Whitefield  McKinlay. 


Wm.  H.  Baldwin,  Chairman. 


F.  L.  Siddons. 
Emmett  L.  Adams. 
Wm.  F.  Downey. 


BOCIAL   betterment   COMMITTEE. 

Geo.  M.  Kober,  Chairman. 


Emmett  L.  Adams. 
Mrs.  Thomas  T.  Gafif. 
Miss  Mabel  T.  Boardman, 


Geo.  M.  Sternberg. 


committee    on    BUILDING    REGLTLATIONS. 

Frederick  L.  Siddons,  Chairman. 
I  Wm.  H.  Baldwin. 
finance  committee. 
S.  W.  Woodward,  Chairman, 


Jamea  B.  Reynolds. 
Mrs.  Thomas  T.  Gaff. 
F.  L.  Siddons. 


John  B.  Sleman,  Jr. 

P.  J.  Brennan. 

Miss  Mabel  T.  P>oardman. 


H.  C.  Macatee,  Assistant  Secretary. 
GusTAvus  A.  Weber,  Statistician, 


TABLE  OF  CONTENTS.     ^^   , 

Letter  of  transmittal ^tlH^i vii 

The  President's  Homes  Commission 1 

Report  of  the  committee  on  improvement  of  existing  houses  and  elimination 

of  insanitary  and  alley  houses 3 

Elimination  of  insanitary  houses 6 

Elimination  of  alley  houses 7 

Report  of  the  committee  on  building  regulations 17 

Resolutions  and  recommendations  of  the  commission 19 

Industrial  hygiene  and  social  betterment 25 

Report  of  the  committee  on  social  betterment 27 

Part  I. — Industeial  Hygienp:. 

Chapter  I. — Introduction 29 

Occupations  and  mortality 30 

Morbidity  and  mortality  of  wage-earners 32 

Indoor  occupations 35 

II. — Occupations  involving  exposure  to  irritating  dust 36 

Metallic  and  mineral  dust 37 

Vegetable  dust 40 

Textile  industries 41 

Animal  dust - 45 

III. — Occupations  involving  exposure  to  infective  matter  in  dust 46 

Rag,  paper,  wool,  and  hair  industry 46 

IV. — Occupations  involving  exposure  to  poisonous  dust — Lead  dust..  48 

The  lead  industry  in  Massachusetts 49 

Printers,  type  founders,  and  typesetters 51 

Arsenical  dust 54 

V. — Occupations  involving  exposure  to  irritating  or  poisonous  gases 

or  vapors 55 

Sulphur  dioxide 55 

Hydrochloric  acid 56 

Sulphuric  and  nitric  acid 56 

Ammonia 57 

Chlorine  gas 57 

Bleaching  establishments 57 

Iodine  and  bromine  vapors 58 

Turpentine 58 

Petroleum 58 

Benzine  vapors 58 

Carbon  monoxide 58 

Carbonic  acid  gas 59 

Carbon  disulphide 59 

Naphtha 59 

Nitrobenzol 60 

Dyeing  and  cleaning 60 

Rubber  industry 60 

Patent-leather  industry 61 

Aniline  vapor 61 

Wood  alcohol 62 

Chrome  pigments 62 

Quinine 62 

Manganese 62 

Brass  founders 62 

Arsenical  fumes 63 

Mercury 63 

Phosphorus 64 

Beet-sugar  industry 64 


m6^S»3 


III 


IV  TABLE    OF   CONTENTS. 

Page. 
Chapter  VI. — Occupations  involving  the  inhalation   of   organic   gases  and 

vapors 65 

VII. — Occupations  involving  exposure  to  extremes  of  heat,  sudden 

changes,  and  abnormal  atmospheric  pressure 65 

Caisson  disease 66 

VIII. — Occupations  involving  constrained  attitudes 67 

IX. — Occupations  involving  over  exercise  of  parts  of  the  body 67 

X. — Occupations  involving  exposure  to  machinery,  etc 67 

Coal  mining 68 

Railway  service 71 

Railway  accidents 71 

Accidents  and  injuries 73 

XI. — Employment  of  women  and  children 74 

XII. — Special  measures  for  the  prevention  of  tuberculosis  among 

wage-earners 80 

XIII. — Measures  for  the  protection  of  wage-earners 81 

Sanitation  of  workshops  and  quarters  for  employees 82 

Cubic  air  space  and  amount  of  fresh  air  per  hour 83 

Ventilation 84 

Temperature 86 

Humidity  of  the  air 87 

Lighting 88 

Artificial  light 88 

Prevention  of  accidents 89 

Miscellaneous  sanitary  provisions 91 

Lodging  houses  and  sleeping  quarters 93 

Permanent  expositions  devoted  to  industrial  and  social 

betterment  of  wage-earners 93 

XIV. — What  the  Federal  Government  may  do  for  the  promotion  of  the 

welfare  of  its  employees 94 

German  workingmen's  insurance  system 95 

XV. — What  the  employer  may  do  for  the  welfare  of  employees 100 

XVI. — What  the  general  public  may  do 102 

XVII. — What  the  employee  may  do  to  contribute  to  his  own  welfare. .  107 

Part  II. — Social  Betterment. 

Chapter  I. — How  to  keep  well  and  capacitated  for  work 109 

H ouse  and  home 109 

House  cleaning 110 

Temperature Ill 

Insects Ill 

Care  of  the  skin 113 

Ablutions  and  baths _ 113 

•    Clothing 114 

Bed  and  bedding 117 

Sleep 117 

Importance  of  good  teeth 119 

Habit  and  regularity  of  the  bowels 120 

Care  of  the  eyes 120 

Care  of  the  ear  and  nose 121 

IL — Alimentation  and  foods 121 

Animal  food 127 

Vegetable  food 132 

Combination  of  food 135 

Storerooms 136 

Preparation  of  food  for  cooking 137 

Cooking  and  eating  utensils 137 

Volume  of  food 138 

Meal  hours 138 

Good  food  at  reasonable  cost 139 

Approximate  weight  and  nutritive  value  of  an  average  por- 
tion of  some  common  food 142 

Food  value  of  breakfast 143 

Food  value  of  lunch 1 44 

Food  value  of  dinner 144 

Food  value  of  day's  ration 144 


TABLE   OF   CONTENTS.  V 

Chapter  II. — Alimentation  and  foods — Continued.  Page. 

Food  and  home  betterment 150 

Menus  for  winter  months 151 

Menus  for  summer  months 152 

Cooking  recipes  for  winter  menus 152 

Cooking  recipes  for  summer  menus 1.54 

Market  price  of  foods 156 

Quantities  of  material  to  be  used 156 

III. — The  causes  and  prevention  of  infectious  diseases 157 

Danger  periods  in  hfe. 157 

Sick  room,  care  and  disinfection 162 

Consumption 165 

Pneumonia 173 

Influenza  (*'la  grippe") 174 

Typhoid  fever 175 

Causes  of  typhoid  fever 177 

Typhoid  fever  in  the  rural  districts 179 

Why  is  there  more  typhoid  fever  in  Washington  than  in 

northern  cities 180 

Diarrhea  and  dysentery 182 

IV. — Infantile  mortality 18  3 

Maternal  nursing 188 

The  anatomical  and  physiological  characteristics  of  infants.  189 

Care  of  the  breasts 190 

Frequency  of  nursing 190 

Weaning  of  infants 191 

Cow's  milk  as  a  cause  of  disease 193 

Milk  sediments  or  dirty  milk 193 

Production  of  pure  milk 195 

Certified  milk 195 

Pasteurized  milk 11)6 

Pasteurizing  plants — milk  depots 1 96 

Advantages  and  disadvantages  of  pasteurized  milk 196 

Home  treatment  of  nursery  milk 198 

Quantity  of  food  for  each  feeding 199 

Care  of  the  nursery  refrigerator,  nursing  bottles,  nipples, 

utensils,  etc 199 

V. — The  prevention  of  permanent  disabilities  in  children 200 

VI.— The  health  of  the  city  of  Washington 204 

Relations  of  water  supply  and  sewers  to  health 206 

Filtration  of  the  Potomac  water 207 

Influence  of  sewers  upon  the  health  of  the  community 207 

Decrease  in  death  rates  since  1875  ._- 209 

Causes  of  large  death  rates  among  the  colored  race 210 

Regeneration  of  housing  conditions 212 

The  present  situation 212 

Congress  and  the  health  of  the  District 213 

VII. — Sexual  and  moral  prophylaxis 213 

Vice  diseases 215 

Syphilis 220 

Gonorrhea 221 

Crusade  against  the  social  evil 222 

Educational  methods 225 

State  methods 227 

VIII.— The  tobacco  habit 229 

IX.— The  alcohol  question 230 

Fermented  liquors 280 

Wines  and  fruit  wines 231 

Beers 232 

Brandv 233 

Rum  ; 233 

Whisky 234 

The  nation's  drink  bill 234 

Alcohol  as  a  foodstuff 337 

Physiological  effects  of  alcohol 237 

Pathological  effects  of  alcohol 238 

Alcohol  increases  the  susceptibility  to  disease 238 

Effects  of  alcohol  upon  longevity 239 


VI  TABLE    OF   CONTENTS. 

Chapter  IX. — The  alcohol  question — Continued.  Pflge. 

Effects  of  alcohol  upon  mental  and  moral  faculties 239 

Alcohol  as  a  cause  of  accidents 240 

Causes  of  intemperance 241 

Poverty  and  drink 242 

Remedial  measures. .'. 244 

List  of  alcoholic  proprietary  medicines 246 

Recreations  and  inexpensive  amusements 249 

X.  —The  drug  habit 251 

Danger  of  soft  drinks  containing  habit-forming  drugs 256 

Remedial  measures  for  the  victims  of  the  alcohol  and  drug 

habit 257 

Advertised  habit  cures 259 

The  harmful  effects  of  so-called  "ethical  pro])rietary  medi- 
cines, acetanilid,  antipyrin,  and  phenacetin" 260 

Thyroid  extracts  in  obesity  or  antifat  cures 261 

The  nostrum  evil  in  general 202 

Prevention    of    conception    and    feticide — Regulation    of 

families 264 

Infanticide  by  systematic  drugging  of  childi  en 266 

Diphtheria  cures 267 

Injury  and  death  to  the  adolescent 268 

Consumption  cures 268 

Asthma  and  hay  fever  cures 269 

Catarrh  cures 270 

Skin  cures 271 

Rheumatism  cures . .- 272 

Kidney  and  bladder  cures 273 

Cancer  cures 274 

Epilepsy  cures 274 

The  miracle  workers 277 

Other  forms  of  quackery 278 

Topical  remedies 278 

Prescription  nostrums 279 

Efficient  work  of  the  Post-Office  Department  and  of  the 
Department  of  Agriculture  in  enforcing  the  law  arouses 

opposition 281 

Conclusions  and  recommendations 283 

XI. — Sociological  study  of  1,251  families 284 

Living  conditions 286 

Income  and  expenditures 287 

Occupations 290 

Employment 292 

Wage-earners'  lunches 293 

Sickness 293 

Insurance 294 

Installment  payments 295 

Illiteracy 295 

School  attendance 296 

XII. — The  business  relations  of  wage-earnersN 297 

XIII. — The  scale  of  wages  and  the  cost  of  living 300 

Compensation  of  government  employees 303 

XIV. — Suppression  of  usury.'. 305 

The  money  borrower 307 

The  money  lenders  and  their  methods 308 

Remedy  proposed 310 

XV. — How  to  benefit  the  poor  in  the  slums 318 

Appendix  A.  Healthof  employees  in  the  Government  Print- 
ing Office,  Washington,  D.  C,  Wm.  J.  Manning,  M.  D..  323 
Appendix  B.  Regulation  of  dangerous  trades  in  England. . .  328 
Appendix  C.  Letters  from  Professor  H.  W.  Wiley  and  Dr. 
L.  T.  Kebler,  Bureau  of  Chemistry  U.  S.  Department  of 

Agriculture 371 

Judge  de  Lacy 's  letter 380 


LETFER  OF  TRANSMIITAL. 


To  THE  Senate  and  House  of  Eepresentatives  : 

I  transmit  herewith  reports  by  the  President's  Homes  Commission 
on  improvement  of  existing  houses  and  elimination  of  insanitary  and 
alley  houses,  on  social  betterment,  and  on  building  regulations,  to- 
gether with  resolutions  and  recommendations  adopted  by  the  com- 
mission, and  ask  that  they  receive  the  careful  consideration  of  the 
Congress. 

Theodore  Roosevelt. 

The  White  House, 

January  5, 1909. 


THE  PRESIDENT'S  HOMES  COMMISSION. 


REPORT    OF    THE    COMMITTEE    ON    IMPROVEMENT   OF 

EXISTING    HOUSES  AND   ELIMINATION   OF 

INSANITARY  AND  ALLEY  HOUSES. 

BY 

WILLIAM  H.  BALDWIN, 

Chairman  of  the  Committee. 


COMMITTEE. 

WILLIAM  H.  BALDWIN.  T.  C.  PARSONS. 

F.  L.  SIDDONS.  WILLIAM  F.  DOWNEY. 

S.  W.  WOODWARD.  PROF.  GEO.  W.  COOK. 

EMMETT  L.  ADAMS. 


S.  Doc.  644,  60-i 


REPORT  OF  THE  COMMITTEE  ON  IMPROVEMENT  OF  EXISTING 
HOUSES  AND  ELIMINATION  OF  INSANITARY  AND  ALLEY 
HOUSES. 


The  report  of  the  committee  on  the  improvement  of  existing  houses 
and  the  elimination  of  insanitary  and  alley  houses  naturally  relates 
to  the  improvement  of  houses  which  are  in  any  way  unsafe  or  detri- 
mental to  the  health  or  morals  of  their  occupants,  or  in  case  the 
owners  do  not  think  it  worth  while,  or  are  unwilling  to  put  them  into 
proper  condition,  to  their  demolition,  in  order  that  the  health  of  the 
people  may  not  be  injured  by  reason  of  them.  Closely  connected  with 
the  latter  part  of  the  subject  is  the  question  of  alley  houses,  which 
may  be  structurally  fit  for  habitation  but  which  are  so  located  as  to 
make  it  practically  impossible  to  supply  them  with  proper  sanitary 
conveniences,  or  to  make  the  moral  and  social  surroundings  what 
they  ought  to  be. 

IMPROVEMENT  OP  EXISTING   HOUSES. 

At  the  time  the  committee  made  its  preliminary  report  it  was  stated 
that  the  work  of  improving  existing  houses  was  being  wisely  and 
effectively  carried  on  by  the  board  for  the  condemnation  of  insanitary 
buildings,  under  the  law  of  May  1,  1906.  The  evils  due  to  the  condi- 
tion into  which  a  large  number  of  ihe  temporary  and  cheap  structures, 
rendered  necessary  by  circumstances  succeeding  the  war,  had  fallen 
was  long  ago  recognized,  and  in  1872  the  board  of  health,  which  had 
been  created  by  an  act  of  Congress  in  the  previous  year,  formulated 
a  specific  ordinance  covering  the  condemnation  of  insanitary  dwell- 
ings, under  which  in  1874,  S89  were  condemned,  followed  by  198  in 
1875  and  371  in  1876 ;  but  the  work  was  stopped  not  long  afterwards 
by  the  reorganization  of  the  health  department,  in  which  the  power 
to  condemn  buildings  unfit  for  habitation  was  not  provided  for." 

The  necessity  for  further  action  continued,  and  as  early  as  1897 
definite  steps  were  taken  toward  the  passage  of  a  bill  providing  for  the 
condemnation  of  buildings  dangerous  to  the  health  or  their  occupants. 
These  efforts  were  continued  during  successive  years  and  in  March, 
1902,  the  Associated  Charities  formed  a  subcommittee  on  the  improve- 
ment of  housing  conditions,  of  which  the  first  purpose  was  stated  to 
be  the  passage  of  a  law  which  would  enable  the  District  Commission- 
ers, through  the  health  department,  to  require  the  adequate  repair  or 
removal  of  dwellings  unfit  for  human  habitation ;  but  each  year  some 
objection  to  the  proposed  bill  was  made  and  it  was  not  until  May  1, 
1906,  after  nine  years  of  effort,  that  it  was  passed  in  its  present  form. 
The  necessity  of  the  bill,  and  the  care  with  which  it  had  been  drawn, 
are  shown  by  the  excellence  of  the  results  obtained  under  it. 

<»  Housing  Movement  in  City  of  Washington,  Dr.  G.  M.  Kober,  p.  6. 


4  EEPOETS  OF  THE  PBESIDENT's  HOMES  COMMISSION. 

The  board  to  whom  the  enforcement  of  the  law  is  by  the  act  itself 
committed  consists  of  the  assistant  to  the  Engineer  Commissioner  in 
charge  of  buildings,  the  health  officer,  and  the  inspector  of  buildings 
of  the  District,  but  the  immediate  execution  of  its  requirements  is  in 
the  hands  of  an  inspector  who  is  thoroughly  interested  in  his  work, 
and  who  has  helped  to  administer  the  law  in  such  a  way  as  to  secure 
the  necessary  results  with  the  least  possible  hardship  to  the  people 
who  have  been  compelled  by  the  destruction  of  the  houses  in  which 
they  were  living  to  seek  shelter  elsewhere. 

Active  work  under  the  law  was  begun  on  July  1,  1906,  and  during 
the  two  years  ending  on  June  30, 1908,  the  results  had  been  as  follows : 


Examined. 

Demol- 
ished. 

Repaired. 

Pending. 

Allevs                                                                

331 
628 

213 
332 

97 

127 

21 

Streets  

169 

Total 

959 

545 

224 

190 

Of  the  769  buildings  acted  on  204  had  been  demolished  and  94 
repaired  in  the  first  year,  and  341  were  demolished  and  130  repaired 
in  the  second  year. 

It  will  be  noticed  that  in  the  year  1907  the  houses  demolished 
amounted  to  68.4  per  cent  of  the  cases  disposed  of  and  72.5  per  cent 
in  the  second  year. 

It  is  probable  that  the  proportion  of  houses  demolished  will  be 
smaller  in  future,  as  the  accumulation  of  dilapidated  buildings  ac- 
counts for  a  considerable  portion  of  those  which  have  been  removed, 
and  the  tendency  as  to  those  which  remain  is  to  make  repairs.  This 
has  been  done  in  a  large  number  of  cases,  and  in  addition  many 
buildings,  equal,  as  far  as  can  be  determined  by  permits  issued,  to 
three-quarters  of  those  repaired  by  order  of  the  board,  have  been 
voluntarily  repaired  and  put  into  proper  condition  by  their  owners 
because  they  have  known  that  if  this  was  not  done  the  board  could, 
and  would,  take  action  in  regard  to  them. 

The  benefit  which  has  resulted  to  those  of  the  community  most  in 
need  of  help  through  the  salutary  provisions  of  this  law  is  apparent, 
and  it  is  a  matter  of  congratulation  that  in  accomplishing  these  satis- 
factory results  there  has  been  so  little  friction  or  complaint  of  arbi- 
trary or  unjust  action. 

During  the  last  year  6  cases  were  referred  to  the  corporation  coun- 
sel for  appropriate  action  in  the  police  court.  In  one  case  the  owner 
was  fined  $10  for  failure  to  demolish,  and  in  another  the  party  was 
sent  to  the  workhouse  for  five  days  for  contempt  of  court,  while  the 
remaining  cases  ended  in  proper  action  by  the  defendants.  These 
instances  emphasize  the  sincerity  with  which  the  law  has  been  exe- 
cuted. 

The  law  contains  a  provision  for  appeal  to  the  supreme  court  of 
the  District  from  the  orders  of  the  board,  and  two  such  appeals  were 
made  during  the  last  year ;  but  in  one  case  it  was  shown  that  the  time 
for  appeal  had  expired,  and  the  other  case  was  abandoned,  so  that 
the  9  houses  involved  in  both  were  demolished  without  further  delay 
or  any  cost  to  the  board. 


BEPOBTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  5 

For  the  94  houses  repaired  in  1907  no  record  of  the  number  of 
occupants  was  kept.  The  130  repaired  in  1908  contained  609  people 
who  were  benefited  by  the  improvement,  an  average  of  4.7  per  house. 

The  number  of  people  whose  lives  have  been  made  more  comfort- 
able by  repairs  voluntarily  made  by  the  owners  of  the  houses  on  ac- 
count of  this  law  can  not,  of  course,  be  determined,  but  it  is  evident 
that  a  most  gratifying  advance  in  the  standard  of  living  has  been 
made  and  that  the  reproach  of  Washington  in  this  respect  is  being 
taken  away. 

This  does  not  mean  that  these  homes  are  as  yet  all  that  could  be 
desired,  or  that  other  improvQments  in  these  and  other  houses  might 
not  well  be  made ;  but  to  interfere  with  the  independence  of  citizens, 
so  long  as  the  conditions  in  which  they  live  are  not  dangerous  to  the 
health  or  morals  of  themselves  or  others,  would  be  doing  an  indirect 
injury  to  our  political  and  social  status,  and  it  is  far  better  that  the 
further  improvement  should  be  worked  out  by  other  influences  than 
the  strong  arm  of  the  compelling  law. 

In  its  last  report  the  board  for  the  condemnation  of  insanitary 
buildings  says: 

Bad  housekeeping  and  general  neglect  are  responsible  for  a  great  many 
houses  being  brought  to  the  attention  of  the  board,  where,  by  proper  attention 
to  the  ordinary  household  duties,  there  would  be  no  occasion  for  complaint. 
The  throwing  of  ashes  and  rubbish  in  the  back  yard,  instead  of  placing  it  in 
cans  for  authorized  collectors,  results  in  the  yard  being  elevated  above  the 
door  in  such  a  manner  that  ventilation  under  the  floor  is  prevented,  and  it  is 
possible  for  water  to  flow  in  during  rain  and  snow  storms,  causing  the  floors 
to  be  damp.  The  habits  of  different  tenants  can  be  better  noted  in  rows  of 
houses  where  they  are  occupied  under  the  same  general  conditions  and  the 
character  of  the  houses  is  practically  the  same.  One  will  be  found  in  a 
clean  and  sanitary  condition;  others  will  be  found  filled  with  a  general  ac- 
cumulation of  trash,  with  no  attempt  whatever  to  keep  even  within  a  semblance 
of  cleanliness. 

In  the  annual  report  for  1907  the  board  called  attention  to  the  fact  that  some 
provision  should  be  made  for  a  school  wherein  good  housekeeping  could  be 
taught,  in  order  to  teach  the  ignorant  how  to  properly  take  care  of  themselves 
and  their  homes,  which  is  an  absolute  benefit  both  to  the  occupants  and  the 
adjoining  residents.  Conditions  have  not  materially  changed  since  the  above 
suggestion  was  made  and  the  board,  therefore,  reiterates  the  statement. 

The  inspector  said  that  in  one  case  where  the  board  had  required 
a  sewer  connection  to  be  made,  the  trench  which  was  dug  showed  a 
geological  formation  of  4  feet  2  inches  of  ashes,  which  had  been 
thrown  into  the  back  yard,  instead  of  being  put  into  the  hands  of  the 
collector  of  rubbish  for  removal. 

This  field,  however,  appertains  rather  to  the  work  of  the  committee 
on  social  betterment,  which  has  a  firmer  foundation  on  which  to 
build  now  that  the  experience  of  two  years  has  demonstrated  that 
a  line  has  at  last  been  drawn  in  Washington  below  which  the  con- 
ditions of  any  habitation  can  not  fall  without  its  being  torn  down  and 
removed  by  constituted  authority. 

There  are  still  many  houses  which  need  repairs,  and  others,  through 
the  neglect  of  the  owners,  or  perhaps  as  often  through  the  carelessness 
of  tenants,  are  getting  into  a  condition  which  requires  attention. 
Some,  where  notices  are  now  being  served  by  the  inspector,  have 
become  unfit  since  the  law  was  passed,  showing  the  need  of  constant 
watchfulness ;  but  the  present  method  promises  to  secure  satisfactory 
results. 


6 


EEPOETS  OF  THE  PKESIDEKT  S  HOMES  COMMISSION. 


During  the  last  two  years  a  special  inspector  has  been  working 
under  the  authority  given  to  require  connections,  where  the  street  is 
provided  with  water  and  sewers,  so  that  there  are  now  comparatively 
few  brick  houses,  even  in  alleys,  which  do  not  have  both;  and  ex- 
tensions of  water  pipes  are  being  steadily  made.  Residents  who  fail 
to  comply  with  the  order  to  connect  are  taken  into  the  police  court, 
and  in  case  of  nonresident  owners  the  District  government  now  makes 
the  needed  improvements,  under  the  compulsory  drainage  act,  and 
charges  the  cost  up  against  the  property. 

The  building  regulations  require  8-foot  ceilings  as  a  minimum  and 
all  new  houses  or  additions  must  conform  to  this,  though  repairs  are 
sometimes  permitted  when  ceilings  are  7  feet  6  inches  or  even  not 
higher  than  6  feet  5  inches,  but  where  they  are  lower  than  this  the 
owner  must  either  raise  the  ceiling  or  demolish  the  building,  so 
that  such  cramped  sleeping  rooms  are  being  done  away  with. 

ELIMINATION    OF    INSANITARY    HOUSES. 

As  has  been  intimated,  the  demolition  of  houses  unfit  for  human 
habitation  has  gone  on  steadily  since  July  1,  1906,  and  in  addition 
to  the  545  up  to  June  30,  last,  127  were  torn  down  in  the  next  five 
months,  maJking  672  demolished  in  all,  of  which  245  were  in  alleys 
and  427  in  streets.  The  proportion  is  due  partly  to  the  fact  that 
the  streets  contain  more  houses,  and  partly  to  the  fact  that, 
because  no  more  dwellings  can  be  built  in  alleys,  owners  repair  alley 
houses  which  they  would  destroy  if  they  could  substitute  new  ones 
for  them. 

Up  to  this  time  the  houses  acted  on  have  been  mostly  one  or  two 
story  buildings,  but  there  are  larger  ones  which  need  attention,  some 
of  them  residences  converted  into  flats  which  accommodate  several 
families.  These  are  being  taken  up  and  one  of  them  in  Georgetown, 
a  three-story  brick,  built  in  1834  and  known  as  Foxhall  Mansions,  is 
now  being  torn  down. 

The  committee  has  kept  in  touch  with  this  work  and  there  has 
seemed  to  be  no  occasion,  in  view  of  all  the  circumstances,  to  criticise 
the  rate  at  which  it  is  being  carried  on.  In  certain  cases  the  in- 
spector has  been  obliged  to  extend  the  time  for  the  vacation  of  build- 
ings to  be  demolished  on  account  of  the  inability  of  the  tenants  to 
find  other  dwellings  within  their  means,  and  while  there  should  be 
no  cessation  of  the  activity  of  the  board  the  absorption  of  displaced 
tenants  can  not  be  effected  with  much  greater  rapidity. 

The  persons  compelled  to  vacate  the  dwellings  removed  were  as 
follows : 


Year  ending- 

Houses 
demol- 
ished. 

Persona  displaced. 

Average  per  house. 

Adults. 

Children. 

Total. 

Adults. 

Children. 

Total. 

June  30  1907 

204 
341 

355 
629 

203 

427 

558 
1,056 

1.7 
1.9 

10 
1.2 

2  7 

June  30, 1908 

3  1 

Total ...           

645 

984 

630 

1,614 

1.8 

1.2 

3.0 

The  small  average  is  due  to  the  fact  that  many  of  the  houses  were 
vacant,  especially  in  the  first  year.     Counting  only  those  actually 


REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  7 

occupied,  the  average  number  in  the  families  turned  out  would  prob- 
ably be  five. 

Some  effort  was  made  to  determine  definitely  what  became  of 
these  people,  but  it  has  been  difficult  to  do  this  because  they  quit  the 
premises  at  any  time  after  notice  is  served,  leaving  the  house  vacant, 
and  no  record  is  made  of  them. 

Of  the  1,056  persons  displaced  in  the  last  year  13  were  white,  1  was 
a  Chinaman,  and  1,042  were  colored.     The  report  for  the  year  says4 

A  small  portion  of  these  tenants  is  going  to  the  suburbs  and  rentyig  or 
purchasing  cheap  houses,  but  the  large  majority  are  remaining  within  the  city. 
A  great  many  are  renting  the  ordinary  two-story  brick  and  subletting  rooms, 
or  two  families  rent  one  house  between  them,  one  taking  the  upstairs  and  the 
other  the  downstairs,  converting  it  practically  into  a  two-family  flat,  but  with 
none  of  the  accommodations  usually  found  in  a  building  of  that  character. 
There  is,  at  the  present  time,  an  unquestionable  demand  for  the  cheaper  class 
of  houses  to  take  the  place  of  those  being  destroyed. 

A  further  analysis  of  the  facts  shows  that  the  houses  removed 
during  the  year  ending  June  30,  1908,  were  assessed  for  taxation  at 
$40,800  and  that  they  had  a  rental  value  of  $16,502.40.  The  average 
of  property  in  an  alley  which  was  investigated  as  to  its  assessed 
value  recently  showed  the  land  to  be  35  per  cent  of  the  total,  and 
assuming  that  it  was  40  per  cent  for  that  from  which  the  above  houses 
were  removed,  and  that  the  actual  value  of  the  property  is  50  per 
cent  more  than  the  assessed  valuation,  the  rentals  indicate  a  gross 
return  of  16  per  cent  on  the  investment. 

The  rental  value  figures  out  $4.03  per  month  per  house;  but  the 
report  of  the  committee  on  building  of  model  houses  (p.  63)  says 
that  not  one  dwelling  has  been  erected  in  Washington  in  the  last 
five  years  which  could  be  rented  as  low  as  $12  per  month,  and  not 
more  than  15  which  could  be  rented  as  low  as  from  $14  to  $16.50  per 
month.  The  demolition  of  the  houses  in  question,  therefore,  was  not 
offset,  so  far  as  these  people  were  concerned,  by  any  new  provision  of 
which  they  could  avail  themselves,  and  sharing  with  others  houses 
too  expensive  for  one  such  family,  with  all  the  disadvantageslsuch  an 
arrangement  in  houses  not  built  for  the  purpose  involves,  afforded 
about  the  only  means  of  shelter  in  the  city. 

There  are  a  few  vacant  houses  in  alleys  which  rent  for  from  $8 
per  month  up;  but  even  one  of  these  requires  a  considerable  readjust- 
ment of  the  family  budget  for  a  tenant  who  has  been  paying  but  $4, 
and  most  of  the  cheapest  houses  which  are  vacant,  even  in  alleys,  rent 
for  $10  per  month  or  more. 

It  is  evident  that  such  conditions,  in  connection  with  the  incli- 
nation to  demand  more  rent  from  colored  people  who  desire  to  occupy 
decent  houses,  tend  to  keep  rents  high  and  render  living  properly  on 
the  wages  of  a  day  laborer  still  more  difficult. 

THE  ELIMINATION  OF  ALLEY  HOUSES. 

By  far  the  best  way  to  do  away  with  alley  houses  is  to  do  away 
with  the  alleys  by  converting  them  into  minor  streets.  So  much  has 
been  said  and  written  about  the  disadvantages  of  the  alleys  of  Wash- 
ington and  the  evils  of  having  scattered  through  the  heart  of  the 
city  a  population  discredited  by  the  very  location  of  their  dwellings, 
and  the  difficulty  of  caring  for  and  supervising  them  although  really 


8  REPORTS  OF  THE  PRESIDENT'S  HOMES  COMMISSION. 

in  very  close  contact  with  the  best  residences  of  the  city,  that  the 
problem  seemed  to  be  one  requiring  action  rather  than  argument; 
and  as  "  the  rearrangement  of  the  building  space  within  the  larger 
squares  of  the  District  of  Columbia  "  was  stated  by  Mr.  Reynolds 
to  be  one  of  the  purposes  of  the  commission  recommended  in  his 
report  and  as  the  work  of  improving  existing  houses  and  eliminating 
other  insanitary  houses  has  been  progressing  satisfactorily,  as  de- 
scribed above,  this  committee  has  devoted  its  chief  energy  to  assist- 
ing in  the  conversion  of  the  undesirable  alleys  into  minor  streets. 

Under  the  law  of  July  22,  1892,  as  amended  on  August  24,  1894, 
the  Cominissioners  at  the  time  of  the  appointment  of  the  conmiission 
had  taken  action  in  12  cases  upon  the  advice  of  a  board  consisting  of 
the  chief  of  police,  the  secretary  of  the  board  of  charities,  and  the 
surveyor  of  the  District,  which  had  been  appointed  by  the  Commis- 
sioners for  the  purpose  of  investigating  and  advising  them  in  regard 
to  the  alleys  which  most  needed  to  be  opened  up  because  the  conditions 
in  them  were  detrimental  to  the  general  welfare  of  the  city. 

As  was  stated  in  the  preliminary  report  the  progress  of  this  work 
had  been  interrupted  by  the  decision  of  the  Supreme  Court  of  the 
United  States  in  the  Brandenburg  case  on  March  11,  1907,  which 
declared  it  illegal  to  assess  all  the  damages  on  certain  property  as 
provided  by  the  existing  law  unless  the  property  was  found  to  be 
benefited  to  that  extent. 

The  Commissioners  at  the  time  expressed  the  intention  of  having 
the  law  amended  at  the  coming  session  of  Congress  so  as  to  remove 
this  obstacle  and  anticipated  no  difficulty  in  doing  this ;  and  as  noth- 
ing further  could  be  done  in  such  cases  without  this  further  authority, 
the  committee  kept  in  touch  with  the  situation  and  waited  for  the 
necessary  action  to  be  taken. 

In  the  first  days  of  January  last,  before  Congress  convened  after 
the  holiday  recess,  it  was  stated  in  one  of  the  papers  that  the  Engineer 
Commissioner,  who  had  succeeded  to  the  office  after  the  proceSiings 
had  been  begun,  had  recommended  that  the  cases  in  three  of  the  alleys 
be  dropped  because  he  had  inspected  them  and  was  of  the  opinion 
that  the  expenditure  of  the  sums  necessary  to  pay  the  damages  which 
would  be  incurred  in  opening  them  up  as  proposed  would  not  be 
justified. 

One  of  these  cases  is  Blagden's  alley,  square  368,  concerning  which 
the  chief  of  police  and  his  associates  on  the  board  stated  in  the  recom- 
mendation for  its  conversion  into  a  minor  street  that — 

Blagden's  alley,  located  between  Ninth  and  Tenth  and  M  and  N  streets,  con- 
tains 54  houses  inhabited  by  a  negro  element  who  live  in  poverty  and  are  a 
source  of  constant  trouble.  The  dwellings  are  insanitary  and  dilapidated  and 
afford  shelter  to  ten  or  twelve  persons  each. 

Another  is  square  620,  as  to  which  the  board  reported : 

Logan's  place  contains  35  insanitary  dwellings,  which  are  very  much  over- 
crowded, and  the  Inhabitants,  being  of  a  vicious  character,  give  the  police  more 
or  less  trouble. 

Everyone  familiar  with  these  and  other  such  labyrinths  realizes 
the  security  from  police  supervision  which  they  afford,  to  say  nothing 
of  other  disadvantages  which  fully  justified  the  recomimendation  of 
the  board. 


BEPORTS   OF    THE  PRESIDENT'S  HOMES  COMMISSION.  9 

There  was  no  suggestion  of  any  other  plan,  and  the  only  reason 
given  was  that  it  was  not  worth  while  to  spend  the  money  required 
to  do  away  with  the  wretched  conditions  by  which  the  city  has  been 
for  so  long  disgraced,  and  as  this  objection,  if  sustained,  would  make 
permanent  such  conditions  in  these  three  alleys,  which  are  among  the 
worst  in  the  city,  and  put  the  whole  matter  upon  a  different  basis,  the 
committee  took  the  subject  up  with  the  Commissioners  and  strongly 
urged  that  no  effort  be  spared  to  pursue  the  original  plan  of  the 
Commissioners,  and  to  provide  some  way  by  which  they  could  proceed 
to  open  up  such  alleys  as  they  might,  after  investigation,  think  it  worth 
while  to  convert  into  minor  streets.  These  suggestions  were  cordially 
received  by  the  other  two  Commissioners,  and  it  was  understood  that 
the  subject  would  be  discussed  with  the  corporation  counsel  with  a 
view  to  arriving  at  the  best  way  of  accomplishing  this  object,  and 
that  any  assistance  which  the  committee  could  give  would  be  wel- 
comed. 

The  committe  therefore  consulted  with  the  corporation  counsel  and 
looked  up  the  law  in  other  places,  but  as  one  of  the  Commissioners 
was  compelled  to  go  to  the  hospital  for  a  considerable  stay,  not  long 
after  this,  further  action  was  delayed.  The  situation,  which  was  fully 
reported  to  the  commission  at  a  meeting  held  January  17, 1908,  seemed 
so  serious  that  the  commission  adopted  a  resolution  urging  that  the 
District  Commissioners  "  take  all  possible  steps  toward  opening  alleys 
into  minor  streets  in  each  case  recommended  by  the  committee  ap- 
pointed for  the  purpose,  and  that  such  changes  in  the  present  law  be 
recommended  by  the  Commissioners  as  will  permit  the  conversion  of 
these  alleys  or  any  others  into  minor  streets,  to  the  end  that  all  such 
alleys  may  within  a  reasonable  time  be  done  away  with;"  and  the 
report  of  the  committee,  with  this  resolution,  was  submitted  to  the 
Commissioners  by  the  chairman  of  the  President's  Homes  Com- 
mission. 

The  principal  difficulty  with  the  present  law  seemed  to  be  that  it 
required  that  an  amount  equal  to  the  damages  found  should  be  as- 
sessed as  benefits  and  that  this  should  be  assessed  within  a  limited 
area.  It  was  found  tliat  the  law  of  1906  in  relation  to  the  opening, 
extension,  widening,  or  straightening  of  streets,  provided  that  the 
jury  should  assess  benefits  not  only  upon  adjoining  and  abutting  prop- 
erty, but  upon  any  and  all  other  lots,  pieces,  or  parcels  of  land  which 
the  jury  might  find  to  be  benefited  by  the  improvement.  This  ap- 
parently indicated  a  plan  by  which  the  amounts  required  could  be 
raised  in  a  more  equitable  manner,  but  as  it  seemed  probable  that  in 
many  case?  the  damages  awarded  would  even  then  exceed  the  benefits 
which  the  jury  might  find,  it  seemed  desirable  to  include  also  a  pro- 
vision by  which  a  certain  proportion  of  the  awards  could,  if  necessary, 
be  paid  out  of  some  general  fund. 

One  of  the  Commissioners  had  suggested,  when  the  Engineer  Com- 
missioner recommended  that  the  work  be  stopped  on  account  of  the 
expense,  that  legislation  might  be  urged  providing  that  the  alleys 
be  opened  and  a  certain  proportion  of  the  expense  be  paid  by  the 
United  States  Government,  another  portion  by  the  District  govern- 
ment, and  the  remainder  be  assessed  upon  the  property  owners  in  the 
neighborhood  of  the  improvement  Inasmuch  as  the  deplorable  con- 
ditions of  the  alleys  have  grown  up  under  the  administration  of  the 


10  REPORTS  OF  THE  PRESIDENT'S  HOMES  COMMISSION. 

District  government,  it  seems  proper  that  a  considerable  portion  of 
the  expense  of  removing  them  should  be  borne  in  this  way  by  those 
responsible  for  them;  but,  as  any  payment  for  District  purposes  by 
the  Federal  Government  would  be  contrary  to  the  definite  policy 
adopted  by  Congress,  it  did  not  seem  advisable  to  the  committee  to 
advocate  such  a  provision. 

In  order,  however,  to  expedite  the  passage  of  any  bill  recommended 
and  to  profit  by  the  advice  of  the  District  Committee  in  each  House 
of  Congress,  as  well  as  to  secure  their  cooperation  in  any  plan  which 
might  be  proposed,  the  committee  consulted  with  the  chairman  of 
each  of  the  District  Committees  as  to  what  fair  provision  would  be 
most  effective.  The  chairman  of  the  Senate  Subcommittee  on  Streets 
and  Avenues  declared  that  conditions  which  he  had  himself  recently 
witnessed  in  the  alleys  of  the  city  ought  nowhere  to  exist,  and  that 
he  would  be  glad  to  do  all  he  consistently  could  to  remove  them. 
After  full  discussion  he  stated  that  if  the  amount  to  be  paid  from  the 
general  funds  of  the  District  could  be  limited  to  25  per  cent  of  the 
total  damages  awarded  in  any  case,  and  the  remainder  be  assessed 
upon  any  property  benefited,  he  would  earnestly  recommend  such  a 
provision,  with  the  full  expectation  that  such  a  bill  might  be  promptly 
passed  by  Congress. 

The  chairman  of  the  House  committee,  when  consulted,  concurred 
in  this  view  and  promised  similar  cooperation.  A  meeting  of  the 
commission,  at  which  this  plan  was  unanimously  indorsed,  was 
promptly  held  and  the  recommendation  for  such  a  bill  was  imme- 
diately put  before  the  Commissioners  by  the  committee,  with  every 
reason  to  expect  that  it  would  be  promptly  acted  upon,  so  that  the 
measure  might  be  passed  before  Congress  adjourned. 

Notwithstanding  the  fact  that  two  of  the  Commissioners  were 
heartily  in  favor  of  the  general  plan,  the  matter  was  delayed,  and 
upon  inquiry  it  was  found  that  the  Engineer  Commissioner  strongly 
objected  to  the  plan  proposed,  on  the  ground  that  no  jury  would  be 
apt  to  assess  in  any  case  more  than  75  per  cent  of  the  damages  found, 
and  that  in  this  way  the  District  would  be  made  to  pay  for  25  per 
cent  of  the  cost  of  opening  many  alleys  and  minor  streets  in  property 
where  the  expense  should  all  be  borne  by  the  property  owners  who 
requested  it.  As  further  investigation  developed  the  fact  that  there 
are  numerous  cases  of  this  kind  to  which  it  was  not  intended  to  have 
this  provision  apply,  the  matter  was  again  taken  up  with  the  corpora- 
tion counsel  and  a  modification  adopted  limiting  the  operation  of 
this  provision  in  each  case  to  the  conversion  of  alleys  into  minor 
streets  running  through  the  block. 

When,  however,  this  reached  the  Engineer  Commissioner  he  still 
objected  to  the  bill  on  the  ground  that  it  was  likely  to  do  injustice  to 
the  District,  declaring  that  juries  would  not  assess  greater  damages 
in  any  case  than  they  were  compelled  to  and  that  the  only  way  to  meet 
the  situation  was  to  introduce  a  special  bill  in  Congress  for  each  alley. 

As  the  special  bills  introduced  for  this  purpose  in  reference  to 
squares  1020,  878,  and  801  had  received  no  attention  and  the  amount 
of  effort  needed  to  secure  the  passage  of  any  bill  is  very  great,  and  as 
it  would  be  necessary  in  the  case  of  each  special  bill  to  take  up  the 
attention  of  Congress  with  the  objections  of  interested  parties  which 
could  better  be  considered  and  attended  to  by  the  Commissioners,  who 


EEPOBTS   OF   THE  PRESIDBlirT's  HOMES  COMMISSIOK.  11 

have  m<M*e  immediate  knowledge  of  the  circumstances,  the  committee 
still  urged  that  the  plan  proposed  by  the  bill  be  followed  and  that  the 
solution  of  the  alley  problem  be  not  simply  left  to  a  system  under 
which  it  has  been  growing  steadily  worse. 

It  was  therefore  suggested  that  the  whole  subject  be  taken  up  at 
a  conference  of  the  Ck)mmis.sioners,  the  corporation  counsel,  and  the 
committee ;  but  the  conferences  and  references  had  taken  so  much  time 
that,  on  account  of  the  legislative  situation  developed  toward  the 
close  of  the  last  session  of  Congress,  it  was  by  this  time  found  that  the 
enactment  of  the  measure  at  that  session  was  wholly  impossible,  and 
the  proposed  conference  was  not  held  until  May  29. 

At  this  conference  the  three  Commissioners,  with  two  assistants  of 
the  corporation  counsel  and  the  surveyor  and  two  members  of  the 
committee,  were  present.  The  whole  subject  was  thoroughly  dis- 
cussed, and  the  objection  of  the  Engineer  Commissioner  that  the 
proposed  amendment  might  result  in  the  payment  by  the  District  of 
some  of  the  damages  in  certain  cases  where  they  ought  to  be  paid  by 
the  property  owners  was  considered,  as  well  as  the  objection  that 
even  under  this  provision  some  alleys  could  not  be  opened,  because 
the  difference  would  still  be  more  than  the  25  per  cent  provided  for. 
One  of  the  other  Commissioners,  however,  met  the  situation  squarely 
by  saying  that,  although  the  law  might  in  this  way  work  some  dis- 
advantage to  the  District  in  certain  cases,  he  thought  this  would  be 
more  than  offset  by  the  advantage  of  having  a  law  under  which  the 
Commissioners  could  proceed  according  to  their  judgment  in  so  many 
cases  in  which  the  alleys  ought  to  be  replaced  by  minor  streets,  and 
that  he  was  ready  to  recommend  the  proposed  bill.  As  there  seemed 
to  be  no  way  of  overcoming  the  objections  of  the  Engineer  Commis- 
sioner, and  no  better  way  of  meeting  the  difficulty,  the  other  Commis- 
sioner declared  that  the  matter  having  now  received  full  considera- 
tion, he  also  would  approve  the  bill.  It  was  therefore  understood 
that  the  bill,  which  is  as  follows,  would  be  promptly  introduced  at 
the  present  session : 

Be  it  enacted  lyy  the  Senate  and  House  of  Representatives  of  the  United  States 
of  America  fh  Congress  AssemUed,  That  section  1608  j  of  the  act  of  Congress 
entitled  "An  act  to  establish  a  code  of  law  for  the  District  of  Columbia," 
approved  March  3,  1901,  as  amended  by  the  act  of  Congress  approved  Feb- 
ruary 23,  1905,  be,  and  the  same  is  hereby,  amended  to  read  as  follows : 

Section  1608  j.  That  said  jury  shall  assess  as  benefits  accruing  by  reason  of 
said  opening,  extension,  widening,  or  straightening  an  amount  equal  to  the 
amount  of  damages  as  ascertained  by  them  as  hereinbefore  provided  including 
five  dollars  per  day  for  the  marshal  and  five  dollars  per  day  for  each  juror 
for  the  services  of  each  when  actually  employed,  and  all  other  expenses  of  such 
proceedings  upon  each  lot  or  part  of  lot  or  parcel  of  land  in  the  square  or  block 
in  which  said  alley  or  minor  street  is  to  be  opened,  extended,  widened,  or 
straightened,  and  upon  each  lot,  part  of  lot,  or  parcel  of  ground  in  the  squares 
or  blocks  confronting  the  square  in  which  such  alley  or  minor  street  is  to  be 
opened,  extended,  widened,  or  straightened,  which  will  be  benefited  by  such 
opening,  extension,  widening,  or  straightening,  in  the  proportion  that  said  jury 
may  find  said  lots,  parts  of  lot^  or  parcels  of  land  will  be  benefited :  Provided, 
however,  That  whenever  the  Commissioners  of  the  District  of  Columbia,  under 
the  foregoing  provisions,  shall  institute  proceedings  for  the  widening  or  extension 
of  any  alley  so  as  to  convert  said  alley  into  a  minor  street  through  the  square  in 
which  said  alley  is  located,  such  an  amount  of  the  total  amount  of  damage  as 
ascertained  by  the  jury,  as  hereinbefore  provided,  including  five  dollars  per 
day  for  the  marshal  and  five  dollars  per  day  for  each  juror  for  the  services 
of  each  when  actually  employed,  and  all  other  expenses  of  such  proceedings, 
fhall  be  assessed  by  the  said  jury  as  benefits,  and  to  the  extent  of  such  benefits 


12  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

upon  each  lot,  or  part  of  lot,  or  parcel  of  land  in  the  square  or  block  in  which 
such  alley  is  to  be  converted  into  a  minor  street,  and  upon  any  and  all  other 
lots,  pieces,  or  parcels  of  land  which  the  jury  may  find  will  be  benefited  by  the 
said  widening  or  conversion  of  such  alley  into  such  minor  street,  as  the  said 
jury  may  find  said  lots  or  parts  of  lots,  pieces  or  parcels  of  land  will  be  bene 
fited ;  and  in  determining  the  amount  to  be  assessed  against  such  lots,  or  parts 
of  lots,  pieces  or  parcels  of  land,  the  jury  shall  take  into  consideration  the 
respective  situations  and  topographical  conditions  of  such  lots,  or  parts  of  lots, 
pieces  or  parcels  of  land,  and  the  benefits  and  advantages  they  may  severally 
receive  from  the  said  widening  or  conversion  of  such  alley  into  such  minor 
street.  If  the  total  amount  of  the  damages  awarded  by  said  jury,  and  the  costs 
and  expenses  of  the  proceeding  be  in  excess  of  the  total  amount  of  the  assess- 
ments for  benefits,  such  excess  shall  be  borne  and  paid  by  the  District  of 
Columbia :  Provided,  That  such  excess  so  to  be  paid  by  the  District  of  Columbia 
shall  in  no  case  exceed  twenty-five  per  centum  of  the  whole  amount  of  the 
damages  as  ascertained  by  the  said  jury. 

The  commissioners  are  not  obliged  to  accept  an  award  unless  they 
think  it  for  the  benefit  of  the  public  to  do  so,  but  can  annul  the  whole 
proceeding,  so  that  they  can  still  fully  protect  the  interests  of  the 
community. 

In  accordance  with  this  understanding  the  bill  was  brought  to  the 
attention  of  the  commissioners  just  before  the  opening  of  the  present 
session  of  Congress.  It  has  received  their  approval  and  is  to  be 
introduced  by  them  with  a  request  for  its  speedy  enactment. 

While  the  committee  is  greatly  disappointed  at  its  failure  to  secure 
the  expected  legislation  at  the  last  session  of  Congress,  it  is  to  be 
hoped  that  the  proposed  measure  will  be  promptly  passed  at  this 
session,  and  that  under  it  the  commissioners  will  be  able  to  reach 
many  cases  of  alleys  which  ought  to  be  opened. 

The  facts  brought  out  in  this  discussion,  when  considered  in  the 
light  of  the  experience  in  other  places,  suggest  the  advisability  of 
going  still  further  in  the  endeavor  to  reach  the  difficulty.  The  Dis- 
trict officials  who  have  had  the  conduct  of  these  appropriation  cases 
are  all  of  the  opinion  that  juries  are,  perhaps  unconsciously,  inclined 
to  be  liberal  in  fixing  the  amount  of  damages  that  are  to  be  awarded 
to  property  owners  and  that  in  the  same  manner  they  are  reluctant 
to  assess  upon  adjoining  property  as  much  benefit  as  it  is  likely  to 
receive  from  the  change  in  conditions.  The  result  of  this  is  that  so 
far  as  the  District  is  called  upon  to  make  up  the  differences  it  suffers 
in  both  ways.  Those  whose  property  is  partly  taken  receive  a  high 
price  for  what  they  dispose  of,  while  the  remaining  portion  is  made 
more  valuable  by  the  street  which  is  opened.  Square  513  contains 
a  minor  street  called  Ridge  street,  which  runs  through  the  block  in 
place  of  the  usual  alley.  An  investigation  made  two  years  since  by 
the  committee  on  improvement  of  housing  conditions  in  this  and  the 
adjoining  square,  No.  512,  which  contains  Kings  court,  showed  that 
the  land  in  the  interior  of  square  513,  where  the  minor  street  had 
been  opened  some  years  before,  was  assessed  for  taxation  at  an  aver- 
age of  $0.41  per  square  foot,  while  the  land  in  the  interior  of  square 
512  in  which  the  alley  conditions  still  remained,  although  having 
more  frontage  in  proportion  to  its  depth,  was  assessed  at  $0.24  per 
square  foot,  indicating,  at  the  ordinary  rate  of  valuation,  actual 
values  in  each  case  of  $0.36  and  $0.62  per  square  foot,  more  than 
70  per  cent  greater  in  the  square  with  the  minor  street. 

The  lots  fronting  on  Ridge  street  contain  127,332  square  feet,  on 
which  a  difference  of  26  cents  per  square   foot   would    amount   to 


EEPOETS   OF  THE  PKESIDBNT's  HOMES  COMMISSION.  13 

$33,106,  which  was  more  than  the  estimated  cost  of  opening  the  alley. 
One  of  the  last  acts  of  the  committee  on  the  improvement  of  hous- 
ing conditions  was  to  request  the  action  which  was  afterwards  taken 
by  the  Commissioners  in  regard  to  this  square,  which  is  the  only  one 
in  which  the  alley  has  been  actually  converted  into  a  minor  street, 
though  that  in  square  650,  which  was  also  confirmed  by  the  court 
and  in  which  a  difference  about  titles  has  been  cleared  away  by  an 
act  of  Congress  just  passed,  will  now  be  opened  also.  The  total 
cost  of  opening  the  alley  in  square  612  was  $28,851.20,  less  than  the 
difference  in  value  between  it  and  the  adjoining  square. 

It  is  of  course  too  soon  to  tell  whether  an  increase  to  the  level  of 
property  values  in  square  513  will  take  place  in  square  512  on  ac- 
count of  the  improvement,  but  the  suggestion  has  been  made  by 
those  who  are  familiar  with  the  facts  that  if,  instead  of  paying  at 
such  a  high  rate  for  only  part  of  the  property  and  getting  none  of 
the  resulting  benefits,  the  District  would  take  the  whole  of  the  prop- 
erty affected  and  itself  receive  the  benefit  of  the  enhanced  values, 
the  cost  to  the  community  of  removing  the  alley  evils  would  be  very 
much  lessened. 

This  brings  in  a  principle  which  is  new  here  but  which  is  not  un- 
known in  other  countries,  and  to  which  it  has  been  necessary  to  re- 
sort in  England  in  order  to  do  away  with  conditions  which  have 
grown  up  there  much  as  those  in  the  alleys  have  grown  up  here. 

The  housing  of  the  working  classes  act,  which  was  passed  in  1890 
and  which  superseded  and  improved  previous  attempts  in  this 
connection ,«  provided  not  only  that  individual  houses  might  be  con- 
demned as  insanitary,  as  is  done  under  the  law  of  1906  here,  but  also 
that  an  area  containing  streets  and  many  houses  might  be  declared 
"  unhealthy,"  and  taken  over  by  the  local  authority ;  and  that  the 
buildings  might  be  removed,  the  streets  rearranged  and  other  dwell- 
ings erected,  either  by  agencies  to  which  money  would  be  furnished 
by  the  local  authority,  or  if  necessary  by  the  local  authorities  them- 
selves. In  fact,  the  law  made  it  obligatory  upon  the  local  authorities 
in  London  to  provide  housing  accommodations  for  at  least  50  per  cent 
of  the  people  displaced,  which  has  since  been  raised  by  an  amendment 
making  the  required  provision  equal  to  all,  and  in  other  districts 
to  such  an  amount  as  might  be  determined  by  the  local  authority 
to  be  adequate  under  all  the  circumstances. 

Under  this  housing  of  the  working  classes  act  numerous  wretched 
districts  have  been  cleared  up  and  comfortable  and  healthy  dwellings 
provided;^  and  although  the  cost  to  the  community  has  been  con- 
siderable in  certain  cases,  where  the  evils  to  be  remedied  were  of 
long  standing  and  very  great,  the  law  has  done  great  good,  and  the 
attention  of  those  interested  in  the  subject  is  being  given  to  improv- 
ing its  operation  rather  than  to  changing  it  in  any  radical  way.  It 
aims,  so  far  as  possible,  to  protect  the  interests  of  the  community  in 
acquiring  any  property  which  has  become  detrimental  to  the  well 
being  of  the  district,  while  at  the  same  time  dealing  justly  with  the 
owners.  The  method  of  procedure  requires  the  local  authority  to 
take  the  initiative,  and  where  a  loan  is  necessary,  as  it  often  is  where 

oThe  Housing  Handbook,  W.  Thompson,  App.,  p.  1. 
^  Op.  cit.,  p.  45. 


14  BEPOBTS  OF  THE  PRESIDENT'S  HOMES  COMMISSION. 

an  area  is  acquired,  the  plans  for  this  and  for  the  improvement  of 
the  area  must  be  approved  by  the  central  authority  in  London. 

Instead  of  being  fixed,  as  here,  by  a  jury  which  is  subject  to  the 
influence  of  acquaintance  with  those  whose  property  is  under  con- 
sideration, the  values  under  the  English  law  are  fixed  by  an  arbitrator 
who  is  appointed  by  the  central  authority,  the  local  government 
board,  and  who  is  sworn  to  act  "  faithfully  and  honestly,  and  to  the 
best  of  his  skill  and  ability  hear  and  determine  the  matters  referred 
to  him  under  the  provisions  of  the  housing  of  the  working  classes 
act ;  "  «  and  it  is  upon  his  recommendation,  after  careful  and  intelli- 
gent consideration  of  all  the  conditions  and  surroundings,  that  the 
award  is  made. 

It  will  be  noticed  that  the  situation  in  the  District  of  Columbia 
is  similar  to  that  in  England,  in  that  the  District  government  re- 
sembles the  local  authority,  which  can  take  the  initiative  in  regard  to 
any  alleys  which  require  attention,  but  which  can  not  act  without  the 
consent  of  an  authority  not  local,  which  in  the  case  of  the  District  is 
Congress.  % 

The  ordinary  danger  in  giving  to  public  officials,  who  are  in  entire 
control,  considerable  discretion  in  the  disbursement  of  public  funds 
is,  therefore,  removed,  and  it  ought  to  be  possible  for  Congress  to 
give  such  a  plan  a  fair  trial  without  incurring  any  very  great  risk. 

The  committee  is  convinced  that  the  objections  made  to  its  proposed 
amendment  to  the  alley  law  by  some  of  the  District  officials  grew  out 
of  their  sincere  regard  for  the  public  welfare  and  their  reluctance 
to  consent  to  anything  which  would  open  the  way  for  property  owners 
to  get  from  the  public  more  than  they  ought  to  receive  for  property 
taken.  The  committee  was,  and  is,  equally  averse  to  doing  anything 
which  would  open  the  door  to  an  improper  expenditure  of  public 
money,  but  the  very  attitude  of  these  officials,  and  the  clean  record 
which  the  District  government  has  had  in  the  past  so  far  as  anything 
like  what  is  called  "  graft "  is  concerned,  give  ground  for  believing 
it  is  safe  to  allow  some  discretion  in  this  matter ;  and  if  these  officials 
are  as  resolute  in  aggressive  work  as  they  have  been  in  opposing  the 
recommendations  of  the  committee,  they  ought  to  accomplish  much. 

If  in  this  connection  the  responsibility  of  placing  the  valuation 
upon  property  taken  could  be  committed  to  an  arbitrator  duly  ap- 
pointed and  responsible  for  his  record,  as  a  judge  is,  instead  of  to  a 
jury  of  citizens  of  the  neighborhood,  who  act  only  for  one  particular 
case  and  have  no  permanent  responsibility,  the  results  might  be  more 
equitable. 

The  uncertainty  of  awards  by  a  jury  and  the  tendency  to  favor 
property  owners  as  against  the  District  under  the  present  system  are 
clearly  illustrated  by  two  cases  which  were  tried  under  the  present 
law  prior  to  the  Brandenburg  decision,  when  juries  were  expected  to 
find  benefits  equal  to  the  damages  assessed.  Upon  the  second  trial  of 
these  cases,  after  the  first  verdict  had  been  set  aside  and  the  jury  was 
no  longer  under  any  conservative  influence  in  fixing  the  damages  and 
benefits,  the  damages  found  were  much  greater  and  the  benefits  much 
smaller.  If  fixed  after  a  careful  study  of  values  by  some  one  free 
from  any  connection  with  the  property  owners  such  irregularities 
would  be  less  likely  to  occur. 

o  Op.  cit,  App.,  p.  41. 


REPORTS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  15 

With  some  discretion  allowed  which  would  permit  the  District 
officials  to  take  all  instead  of  part  of  any  property  for  whidi  damage 
is  claimed  in  opening  an  alley,  or  to  appropriate  other  connecting 
land,  where  it  seemed  to  the  interest  of  the  community  to  do  so,  land 
might  be  made  available  for  the  erection  of  the  low -rental  houses  so 
much  demanded  by  the  needs  of  men  earning  only  laborer's  wages ;  ° 
and  if  this  could  be  coupled  with  a  reasonable  loan  of  public  funds 
under  proper  safeguards  at  a  low  rate  of  interest,  in  cases  considered 
proper  by  the  District  officials,  the  work  of  the  Washington  Sani- 
tary Housing  Company,  which  halts  at  a  slightly  higher  rate,  would 
be  supplemented,  the  way  for  reconstructive  action  would  be  opened, 
and  the  alley  land  by  which  the  city  is  now  burdened  might  become 
a  source  of  satisfaction  from  an  economic  as  well  as  from  a  social 
standpoint. 

Should  there  be  any  indications  that  any  such  power  granted  by 
Congress  was  being  indiscreetly  or  improperly  used  by  the  officials 
of  the  District  it  could  be  promptly  discontinued;  but  if  the  results 
proved  the  wisdom  of  the  method  it  could  be  continued  and  improved 
on  until  the  alley  problem  is  solved. 

The  committee  hesitates  to  recommend  any  novel  or  i:adical 
measures,  but  calls  attention  to  the  possibilities  which  the  difference 
between  the  government  of  Washington  and  that  of  all  other  cities 
in  the  country  suggests. 

Although  the  erection  of  any  more  buildings  in  alleys  was  practi- 
cally stopped  by  the  act  of  July  22,  1892,  additions  to  the  number 
have  occasionally  been  made  by  converting  buildings  erected  on  alleys 
for  other  purposes  into  dwellings.  Such  an  instance,  in  which  a 
stable  had  been  converted  into  an  alley  dwelling  and  the  second  floor 
occupied  by  two  colored  families,  was  referred  to  the  corporation 
counsel  by  the  inspector  of  buildings  in  March  last  and  an  opinion 
rendered  that  such  action  could  not  be  prevented  because  the  act  of 
July  22,  1892,  did  not  apply. 

In  order  to  meet  this  situation  a  bill  forbidding  any  such  con- 
version of  other  building  into  dwellings  fronting  on  alleys  was 
prepared  by  the  conmiission  appointed  to  revise  the  building  laws, 
and  should  receive  prompt  attention  in  order  that  further  evasions 
of  the  alley  law  may  be  prevented. 

In  a  plan  proposed  for  improving  housing  conditions  in  German 
cities  provision  is  made  for  homes  of  working  people  in  narrow 
streets  running  through  and  connected  with  those  portions  in  which 
the  residences  of  people  of  larger  means  are  found,  instead  of  hav- 
ing each  kind  in  a  district  by  itself.  Such  a  plan  would  have  a 
peculiar  advantage  in  this  democratic  country,  where  the  difference 
should  be  not  in  character,  but  simply  in  the  standard  of  living,  and 
would  be  for  the  convenience  both  of  employers  and  employed.     Such 

« In  many  German  cities  considerable  land  acquired  for  the  purpose  of  pro- 
viding homes  for  the  working  classes  is  held  by  the  municipality.  (The  Ex- 
ample of  Germany,  by  T.  0.  Horsfall,  p.  25.) 

The  example  has  been  followed  by  Holland,  in  which  Amsterdam  has  ac- 
quired compulsorily  2,500  acres — nearly  4  square  miles — and  adopted  an  exten- 
sion plan.  Two  other  cities  have  each  about  half  as  much,  and  three  others 
have  smaller  quantities.     (Housing  Up  to  Date,  W.  Thompson,  p.  194.) 

Berlin  had  85  square  yards  per  capita,  which  would,  on  a  basis  of  325,000 
population,  be  equal  to  more  than  5,700  acres  for  Washington. 


16 

a  system  we  practically  have  now  in  the  alley  dwellings,  in  which  the 
contact  with  the  best  residences  of  the  city  is  so  close ;  so  that  by  the 
conversion  of  these  alleys  into  minor  streets,  permitting  decent  living 
and  encouraging  self-respect  in  those  residing  upon  them,  we  could 
establish  a  healthy  social  circulation  in  the  body  politic  by  which  we 
would  obtain  all  the  advantages  of  the  German  plan  while  doing 
away  with  the  conditions  which  are  now  a  constant  menace  to  the 
welfare  of  the  community. 

While  the  committee  is  fully  alive  to  the  perplexities  connected 
with  the  alley  problem,  it  is  also  impressed  with  the  necessity  of 
action  in  regard  to  it.  It  does  not  wish  to  enlarge  on  the  well-known 
reasons  for  opening  the  alleys,  but  it  can  not  admit  that  it  is  not 
"  worth  while,"  even  if  the  process  is  expensive,  to  put  the  city  on  a 
proper  basis;  and  thorough  constructive  work  is,  and  will  be,  im- 
possible as  long  as  so  many  blocks,  fair  on  the  outside,  contain  these 
centers  of  vice  and  misery.  To  refuse  to  remove  them  because  it  costs 
something  is  like  refusing  to  escape  blindness  by  the^  removal  of  a 
cataract  because  of  the  fees  of  the  oculist. 

The  passage  of  the  proposed  amendment  will  enable  the  Commis- 
sioners to  take  up  the  interrupted  cases  and  to  start  others,  under 
which  a  large  number  of  the  alleys  of  the  city  can  be  replaced  by 
desirable  streets. 

So  far  the  way  is  plain,  and  this  experience  will  indicate  the  best 
method  of  reaching  the  others.  The  further  suggestions  are  made 
in  the  hope  that  the  District  government,  which  has  certain  disad- 
vantages under  whioh  these  evils  have  grown  up,  may  be  found  to 
possess  also  certain  advantages  over  other  forms  by  which,  if  they 
are  recognized,  the  evils  may  be  done  away  with  with  less  expense 
than  they  could  be  under  some  other  system,  but  the  committee  is 
firmly  or  the  opinion  that  in  any  event  the  alleys  must  go. 

KespectfuUy  submitted. 

The   Committee   on   Improvement   of 
Existing   Houses   and   Elimination 
OF   Insanitary  and   Alley  Houses. 
By  Wm.  H.  Baldwin,  Chairman. 

Washington,  December  17^  1908, 


Upon  presentation  of  the  above  report,  the  following  resolutions 
were  adopted  by  the  President's  Homes  Commission: 

Resolved,  That  Congress  be  urged  to  promptly  pass  the  amendment  to  the 
code  proposed  by  the  Commissioners,  allowing  a  difference  between  the  damages 
found  and  benefits  assessed  in  any  case  of  the  conversion  of  an  alley  into  a 
minor  street  not  greater  than  25  per  cent  of  the  total  damages,  to  be  paid  out 
of  the  general  fund  of  the  District. 

Resolved,  That  the  Commissioners  be  urged  to  give  prompt  and  constant 
attention  to  the  alley  problem  under  their  present  plan,  In  order  that,  either  by 
the  general  law  or  by  special  act,  all  such  alleys  may,  within  a  reasonable 
time,  be  done  away  with. 

Resolved,  That  a  bill  should  be  promptly  passed  by  Congress  forbidding  the 
conversion  into  dwellings  of  auy  buildings  designed  for  other  purposes  fronting 
on  alleys. 


EEPOBTS   OP  THE  PBESIDBNT's  HOMES  COMMISSION.  17 

REPORT  OF  THE  COMMITTEE  ON  BUILDING  REGULATIONS. 

To  the  Presidents  Homes  Commission: 

Your  committee  on  building  regulations  begs  leave  to  submit  the 
following  report : 

Immediately  after  the  appointment  of  the  committee  it  met  for 
the  purpose  of  considering  the  extent  and  scope  of  its  work.  The 
first  conclusion  reached  b;^  the  committee  was  that  it  was  not  called 
upon  to  attempt  any  revision  of  the  building  regulations  as  they 
affected  the  construction  of  houses  for  the  poorer  or  least  resourceful 
classes  of  the  community,  particularly  in  view  of  the  fact  that,  before 
the  appointment  of  the  committee,  the  District  Commissioners  had 
appointed  a  commission  composed  in  part  of  officials  of  the  District 
government  and  citizens^  for  the  purpose  of  making  a  complete  re- 
vision of  existing  building  regulations.  The  commission  has  been 
in  existence  for  nearly  two  years,  but  has  not  yet  completed  its  work. 
Your  committee  placed  itself  in  touch  with  the  commission  referred 
to,  with  the  result  that  the  commission  courteously  resolved  to  submit 
to  your  committee  such  regulations  as  it  might  recommend  for  adop- 
tion to  the  Commissioners  of  the  District,  with  a  view  of  securing  our 
consideration  and  criticism  of  such  regulations.  Two  of  such  regula- 
tions have  been  referred  by  the  commission  to  your  committee,  the 
first  being  the  regulation  touching  the  important  questions  of  ventila- 
tion and  light.  This  regulation  received  the  careful  consideration 
of  your  committee,  with  the  result  that  several  important  changes 
were  recommended,  most  of  which  were  adopted  by  the  commission 
and  the  District  Commissioners.  This  matter  has  been  the  subject 
of  a  prior  report  by  your  committee  to  the  Homes  Commission. 

The  second  regulation  submitted  covered  the  subject  of  party  walls. 
This  regulation  proposed  a  uniform  width  for  such  walls  of  13  inches 
for  all  dwellings.  It  was,  and  is  the  opinion  of  your  committee,  that 
a  distinction  should  be  made  between  the  width  of  walls  for  a  house 
not  to  exceed  two  stories  in  height  (and  in  that  case  it  was  and  is  be- 
lieved by  the  committee  that  a  9-inch  wall  would  be  sufficiently  wide 
to  absolutely  insure  structural  safety  and  protection  from  fire)  and 
those  for  dwellings  designed  to  be  more  than  two  stories  in  height. 
In  the  latter  cases  the  width  prescribed  by  the  regulation  referred  to 
IS  probably  right.  On  this  point,  as  youv  committee  understands  it, 
the  building  commission  and  the  District  Commissioners  do  not  agree 
with  your  committee. 

Your  committee  further  reports  that  in  August  last  it  recom- 
mended to  the  Commissioners  of  the  District  the  incorporation  in 
the  revised  Code  of  Building  Regulations  of  definitions  of  various 
buildings.  Whether  this  recommendation  received  the  approval  of 
the  commission  and  the  commissioners  or  not,  your  committee  is  not 
informed. 

Your  committee  has  been  embarrassed  in  the  prosecution  of  its 
work  by  what  seems  to  it  to  be  the  delay  on  the  part  of  the  committee 
on  revision  of  the  building  regulations  in  completing  its  work.  Your 
committee  made  the  recommendations  that  it  did,  touching  the  two 
regulations  referred  to  it  as  above  set  forth,  with  the  reservation  that 
its  recommendations  were  subject  to  its  consideration  of  the  full  code 
whenever  it  should  be  completed.  Respectful  suggestions  have  been 
made  by  your  committee  to  the  District  Commissioners  of  the  im- 
S.  Doc.  644,  60-2 3 


18  REPORTS  OF  THE  PRESIDENT'S  HOMES  COMMISSION". 

portance  of  an  early  completion  of  the  work  of  revision  referred  to. 
It  has,  however,  no  information  as  to  when  the  revision  is  likely  to 
be  completed,  and  it  can,  therefore,  make  no  definite,  full,  or  satisfac 
tory  report  upon  the  subject. 

Your  committee,  thinking  that  perhaps  information  of  advantage 
on  the  general  subject  could  be  obtained  from  cities  in  England  and 
on  the  continent  of  Europe,  applied  to  the  Secretary  of  State  to  secure 
from  our  consuls-general  and  consuls  data  upon  the  subject.  The 
Secretary  very  promptly  complied  with  the  request  of  your  committee 
and  directed  that  the  consular  officers  mentioned  collect  and  forward 
as  promptly  as  possible  the  material  called  for,  and  this  has  been 
coming  to  your  committee.  A  considerable  part  of  this  material  is 
not  available  to  your  committee,  because  it  is  not  translated  into  Eng- 
lish, but  information  from  various  English  cities  has  been  forwarded 
and  is  now  in  the  archives  of  the  homes  commission.  The  Right 
Honorable  John  Burns,  chairman  of  the  local  government  board  and 
a  member  of  the  present  British  cabinet,  took  more  than  a  perfunc- 
tory interest  in  the  request  made  of  him  by  our  consul-general  to 
London,  and,  through  the  latter,  forwarded  material  of  interest  and 
value.  But  until  your  committee  knows  what  will  be  embraced  in 
the  proposed  revision  of  the  building  regulations  for  this  District,  the 
practical  use  to  which  the  committee  can  put  the  data  thus  gathered 
IS  problematical. 

In  conclusion,  your  committee  expresses  the  hope  that  an  oppor- 
tunity will  be  afforded  it  of  making  another  report  when  it  has 
received  a  copy  of  the  revised  code  of  building  regulations  and  has 
had  an  opportunity  to  carefully  consider  the  same. 

All  of  which  is  respectfully  submitted. 

F.  L.   SiDDONS,  Chairman, 
Geo.  M.  Sternberg, 
Wm.  H.  Baldwin. 


RESOLUTIONS  AND  RECOMMENDATIONS  OF  THE  COMMISSION. 


At  a  special  meeting  of  the  President's  Homes  Commission,  held 
on  December  17,  1908,  the  following  resolutions  and  recommenda- 
tions were  unanimously  adopted : 

Resolved,  That  in  the  opinion  of  this  commission  the  building  regulations  in 
the  city  of  Washington  should  permit  the  building  of  two-story  brick  buildings 
having  a  frontage  of  not  less  than  14  feet  and  walls  9  inches  thick :  Provided, 
That  such  buildings  have  good  foundations,  satisfactory  ventilation  under  the 
first  floor,  and  bathrooms  with  water  supply  and  sewer  connections. 

Resolved,  That  in  the  opinion  of  this  commission  no  apartment  house  more 
than  three  stories  in  height  should  be  built  in  the  city  of  Washington,  unless 
it  is  of  fireproof  construction  and  is  provided  with  elevators. 

Resolved,  That  in  the  opinion  of  this  commission  the  Congress  of  the  United 
States  should  authorize  the  loan  of  money,  at  a  low  rate  of  interest,  to  building 
associations  organized  for  the  purpose  of  building  sanitary  houses  for  the  work- 
ing classes  in  the  National  Capital ;  satisfactory  real-estate  security  to  be  given 
for  the  repayment  of  such  loans  and  suitable  provisions  enacted  to  Insure 
moderate  dividends  upon  the  capital  invested  in  such  enterprises,  and  low 
rentals  for  the  houses  constructed,  in  order  that  they  may  be  within  the  means 
of  unskilled  wage-earners. 

Resolved,  That  Congress  be  urged  to  promptly  pass  the  amendment  to  the 
code  proposed  by  the  Commissioners,  allowing  a  difference  between  the  damages 
found  and  benefits  assessed  in  any  case  of  the  conversion  of  an  alley  into  a 
minor  street,  not  greater  than  25  per  cent  of  the  total  damages,  to  be  paid  out 
of  the  general  fund  of  the  District. 

Resolved,  That  the  Commissioners  be  urged  to  give  prompt  and  constant  at- 
tention to  the  alley  problem  under  their  present  plan,  in  order  that  either  by 
the  general  law  or  by  special  act  all  such  alleys  may,  within  a  reasonable  time 
be  done  away  with. 

Resolved,  That  a  bill  should  be  promptly  passed  by  Congress  forbidding  the 
conversion  into  dwellings  of  any  buildings  designed  for  other  purposes  fronting 
on  alleys. 

The  following  recommendations  submitted  by  the  committee  on 
social  betterment  were  also  approved: 

1.  The  enactment  of  model  factory  and  labor  laws  for  the  em- 
ployees of  the  Government  and  for  the  District  of  Columbia.  Such 
laws,  apart  from  regulating  the  hours  of  labor,  should  also  make 
adequate  provisions  for  the  sanitation  of  workshops,  for  employer's 
liability  in  case  of  accidents,  and  for  a  comprehensive  system  of 
industrial  insurance  for  all  government  employees  and  employees  in 
the  District  of  Columbia.  (See  pp.  72-93  of  report  submitted  Febru- 
ary 4,  1908.) 

2.  The  appointment  by  the  President  of  a  special  board,  composed 
of  architects  and  sanitarians  now  in  the  employ  of  the  Government, 
for  the  purpose  of  evolving  model  plans  and  building  regulations  for 
government  workshops  and  office  buildings,  so  that  no  such  buildings 
will  hereafter  be  erected  without  due  regard  to  air  space,  ventilation, 
light,  heating,  temperature,  humidity,   sanitary  conveniences,   and 

1» 


20  EEPOBTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

other  provisions,  including  sanitary  supervision  referred  to  in  a 
previous  report,  pages  71  to  83. 

3.  The  establishment  in  the  National  Museum,  and  in  connection 
with  museums  in  industrial  centers  generally,  of  -a  special  section 
devoted  to  exhibits  illustrative  of  the  hygiene  of  occupations,  habita- 
tions, food,  safety  appliances,  and  other  collections  for  the  promotion 
of  industrial  and  social  betterment  of  wage-earners,  along  the  lines 
indicated  on  pages  85  and  86  of  the  report,  February  4,  1908.  It 
may  be  found  necessary  to  house  such  exhibits  ultimately  in  a  special 
building. 

4.  While  it  is  gratifying  to  record  a  very  deep  interest  in  the  public 
schools  of  Washington  in  all  matters  related  to  social  and  industrial 
life,  the  committee  is  of  the  opinion  that  even  greater  emphasis  should 
be  given  in  the  curriculum  to  manual  training  and  domestic  science, 
because  the  practical  knowledge  thus  acquired  not  only  inspires  re- 
spect for  manual  labor  and  domestic  service,  but  constitutes  in  fact 
the  foundation  stone  for  intelligent  work  and  home  making. 

5.  The  importance  of  a  thorough  practical  training  in  domestic 
science  is  nowhere  more  evident  than  in  a  study  of  our  family  groups 
whose  income  is  less  than  $700  a  j^ear.  While  conditions  on  the  whole 
indicate  a  fierce  struggle  for  existence,  some  splendid  examples  of 
neat  and  healthful  homes  of  thrift  and  happiness  could  be  cited  for 
the  emulation  of  less  competent  neighbors. 

6.  Since  the  scale  of  wages  in  certain  occupations  has  not  kept 
pace  with  the  cost  of  living,  the  committee  recommends  adequate 
compensation  of  all  employees,  whether  in  the  government  service 
or  in  other  fields  of  activity.  This  applies  with  special  emphasis  to 
married  men  earning  less  than  $2  a  day.  No  effort  should  be  spared 
to  improve  the  social  condition  of  poorly  paid  wage-earners,  and 
justice  likewise  demands  an  increase  in  the  scale  of  salaried  employees 
in  order  to  compensate  for  the  increased  cost  of  living,  especially 
when  no  such  increase  has  been  made  within  the  past  ten  years.  It 
is  believed  that  the  principle  of  permanency  of  employment,  which 
is  so  well  established  as  to  large  numbers  of  government  employees, 
should  be  extended  to  others  to  whom  it  does  not  now  apply,  so  far 
as  the  interests  of  the  Government  permit 

7.  The  committee  is  of  the  opinion  that  the  standards  of  living 
could  be  materially  improved  by  diminishing  the  expenditures  for 
tobacco  and  intoxicants.  Taken  as  a  whole,  the  families  investigated 
could  add  on  an  average  at  least  one  room  to  their  overcrowded  homes 
if  the  money  expended  for  these  items  were  devoted  to  the  payment 
of  rent. 

In  order  to  restrict  the  consumption  of  these  harmful  agents  much 
may  be  done  by  educational  methods,  the  establishment  of  social 
settlements  in  connection  with  the  public  schools  and  churches,  and 
the  creation  of  genteel  and  inexpensive  amusements  calculated  to 
counteract  the  influence  of  saloons  and  evil  resorts.  The  sale  of 
tobacco  and  intoxicants  to  persons  under  the  age  of  21  should  be  pro- 
hibited by  law.  We  also  recommend  greater  restriction  in  the  sale 
of  proprietary  medicines  containing  alcohol  in  sufficient  quantity  to 
be  intoxicants,  and  greater  restriction  in  the  licensing  of  saloons  in 
residential  and  manufacturing  sections. 


REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  21 

We  also  recommend  the  enactment  of  a  bill  introduced  by  Senator 
Gallinger,  making  drunkenness  a  misdemeanor,  and  placing  habitual 
drunkards  and  drug  habitues  under  legal  restraint  in  the  hospital  for 
inebriates  in  order  to  bring  about  their  permanent  reformation.  The 
committee  believe  that  the  provisions  of  the  bill  will  be  materially 
strengthened  by  making  the  sale  of  intoxicants  to  habitual  drunkards 
a  criminal  offense  and  to  hold  the  seller  responsible  for  all  damages, 
when  properly  warned  not  to  dispense  intoxicants  to  minors  and 
habitual  drunkards. 

8.  The  committee  believes  that  public  playgrounds  and  athletic 
fields  will  promote  temperance  and  chastity,  and  since  we  are  familiar 
with  the  physical  ravages  of  vice  and  disease  and  the  public  expendi- 
tures incident  thereto,  we  reconmiend  most  liberal  appropriations  for 
all  such  moral  and  social  prophylactic  measures. 

9.  Your  committee  believes  that*  quackery  and  the  great  nostrum 
evil  are  frequent  causes  of  physical  and  financial  impoverishment. 
In  view  of  the  importance  of  the  subject,  we  recommend  the  appoint- 
ment of  a  special  board  composed  of  a  representative  of  the  Attorney- 
General  in  the  Post- Office  Department,  of  the  Public-Health  Service, 
and  the  chief  of  the  Bureau  of  Chemistry,  United  States  Department 
of  Agriculture,  for  the  purpose  of  investigation  and  the  formulation  of 
such  additional  legislation  as  may  be  deemed  necessary  in  the  interest 
of  public  health  and  morals. 

In  the  meantime  it  is  earnestly  recommended  that  the  Postmaster- 
General  be  requested  to  publish  with  the  monthly  Supplements  to 
the  Official  Postal  Guide,  a  bulletin  setting  forth  the  essential  facts 
in  connection  with  the  fraud  orders  issued  during  the  preceding 
month,  such  bulletins  to  be  posted  in  post-offices  and  to  be  dis- 
tributed in  sufficient  numbers  along  rural  delivery  routes. 

We  also  recommend  that  all  information  concerning  harmful  in- 
gredients in  foods,  medicines,  soft  and  alcoholic  drinks  which  may 
come  to  light  during  the  execution  of  the  pure  food  and  drug  law 
be  published  by  the  Department  of  Agriculture  in  the  same  manner 
as  "  Farmers'  Bulletins  "  are  now  being  published.  The  public  is 
entitled  to  be  warned,  and  for  this  purpose  the  indisputable  facts 
should  emanate  from  some  official  source. 

10.  The  committee  strongly  recommends  the  enactment  of  a  law 
for  the  suppression  of  usury  as  contemplated  by  Senate  bill  2296  and 
H.  R.  11772.  Your  committee  is  convinced  that  there  is  a  necessity 
in  every  community  for  pawn  shops  and  money-lending  concerns,  to 
aid  persons  who  are  unable  in  an  emergency  to  secure  loans  from 
banks,  trust  companies,  or  real  estate  brokers.  It  has  been  shown 
that  the  system  now  in  vogue  is  attended  with  gross  abuses,  absolute 
extortion,  and  financial  distress  which  calls  for  remedial  action. 
Since  it  has  also  been  demonstrated  by  the  experience  of  the  New 
York  Provident  Loan  Society  (a  strictly  business  philanthropy)  that 
such  operations  can  not  be  carried  on  at  a  lower  rate  of  interest  than 
1  per  cent  per  month,  we  recommend  that  the  maximum  rate  of 
interest  be  placed  not  higher  than  2  per  cent  per  month.  This  will 
legalize  the  business,  enable  respectable  people  to  enter  the  field,  and, 
by  wholesome  competition,  bring  about  the  desired  result.  The 
license  tax  in  the  proposed  bill  should  be  reduced  from  $1,000  to  $100 


22 

per  annum;  a  suitable  reduction  should  likewise  be  made  on  the 
recorder's  fees  on  chattel  mortgages  involving  amounts  less  than  $100, 
as  all  these  expenses  are  placed  by  indirection  on  the  borrower.  The 
execution  of  such  a  law  involves  careful  official  supervision,  such  as  is 
contemplated  in  the  recommendations  of  Mr.  James  Bronson  Rey- 
nolds in  the  creation  of  the  bureau  of  labor. 

11.  The  creation  of  a  bureau  of  labor  would  likewise  render  valu- 
able services  both  to  employers  and  employees  in  the  supervision  of 
employment  agencies,  the  correction  of  abuses  connected  therewith, 
and  also  in  the  enforcement  of  labor  laws,  sanitation  of  factories, 
workshops,  etc. 

The  fact  that  in  our  sociological  study  of  1,217  families  comprising 
a  population  of  4,889,  2,202,  or  45  per  cent,  carried  life  insurance, 
and  855,  of  ITJ  per  cent,  carried  insurance  against  sickness,  constitutes 
a  strong  argument  in  favor  of  a*  comprehensive  system  of  working- 
men's  insurance,  and  adequate  supervision,  such  as  recommended  by 
Mr.  Reynolds  in  his  report  to  the  President,  April  29,  1907. 

12.  Our  sociological  mvestigation  shows  that  out  of  5,157  persons 
enumerated  613,  or  12  per  cent,  had  been  sick  during  the  past  year 
with  an  average  duration  of  29.5  days,  involving  a  loss  of  18.083  days, 
of  work.  This,  together  with  information  collected  by  the  Board  of 
Charities,  emphasizes  the  need  of  hospital  facilities  for  convalescents 
where  the  earning  capacity  of  dependent  patients  after  an  acute  ill- 
ness may  be  expedited.  As  it  is  now,  the  recovery  of  such  persons 
is  greatly  retarded  by  a  return  to  insanitary  homes,  insufficient  and 
improper  food,  etc. 

13.  The  cases  of  permanent  disability  found  in  *the  1,217  families 
are  comparatively  few,  namely  42.  Of  these  the  age  is  given  in  39 ; 
3  of  these  were  under  the  age  of  19  years ;  14  between  20  and  49  years ; 
and  22  were  over  50  years.  This  does  not  include  the  cases  cared  for 
in  public  institutions,  which  are  taxed  to  their  utmost  capacity. 

In  order  to  reduce  the  number  of  defectives,  preventive  measures 
must  be  invoked  early  in  life  and  an  able  corps  of  teachers,  medical 
inspectors,  and  instructive  visiting  nurses  can  render  most  efficient 
service.  A  recent  inspection  of  43,005  pupils  in  the  public  schools 
shows  that  15,304  children,  or  35.2  per  cent  of  the  total  examined, 
are  in  need  of  medical  or  dental  service. 

Your  committee  recomimends  that  the  study  of  hygiene  be  made 
an  important  part  of  the  school  curriculum,  also  the  appointment  of 
instructive  visiting  nurses  in  the  schools,  and  that  medical  inspectors, 
nurses,  and  teachers  be  authorized  to  suggest  to  pupils  and  parents 
the  desirability  of  securing  prompt  professional  advice  in  all  cases 
where  it  is  indicated,  and  especially  in  such  instances  as  are  likely 
to  result  in  permanent  disability. 

14.  In  the  interest  of  general  sanitation  your  committee  recom- 
mends (1)  the  further  purification  of  the  water  supply  advocated 
by  the  officers  in  charge  of  the  filtration  plant;  (2)  the  reclamation 
of  the  Anacostia  Flats  for  the  reduction  of  malarial  fevers;  (3)  the 
enactment  of  a  more  stringent  law  regulating  the  production  and  sale 
of  milk  and  dairy  products,  for  the  reduction  of  milk-borne  diseases ; 
(4)  the  abandonment  of  box  privies,  removal  of  slums,  establishment 
of  public  baths  for  all  seasons  of  the  year,  more  liberal  appropria- 


EEPORTS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  23 

tions  for  the  health  department,  and  a  larger  corps  of  sanitary  in- 
spectors so  that  the  gospel  of  cleanliness  and  health  may  be  enforced 
within  and  without  the  homes;  (5)  greater  cooperation  on  the  part 
of  the  police  courts  with  the  efforts  of  the  health  department  in  the 
enforcement  of  sanitary  laws  and  ordinances. 

Some  of  these  recommendations  have  been  urged  by  the  Commis- 
sioners for  years ;  they  are  of  vital  importance  to  the  health,  not  onlv 
of  every  permanent  resident,  but  of  the  chief  magistrate,  his  cabinet, 
the  foreign  ministers,  thousands  of  public  officials,  the  members  of 
the  Senate  and  House  of  Representatives,  and  all  citizens  having 
business  with  Congress,  besides  the  numerous  visitors  who  annually 
pay  homage  to  the  city  of  Washington. 


INDUSTRIAL  HYGIENE  AND  SOCIAL 
BEHERMENT. 


A  REPORT  OF  COMMITTEE  ON  SOCIAL  BETTERMENT  OF 
THE  PRESIDENT'S  HOMES  COMMISSION. 


BY 


GEORGE  M.  KOBER,  M.  D.,  LL.  D., 

PBOFKSSOR  Qif  HYGIENE,  SCHOOL  OP  MEDICINE,  GEORGETOWN  UNIVERSITY, 

Chairman  of  the  Committee. 


COMMITTEE. 
GEORGE  M.  KOBER.  EMMETT  L.  ADAMS. 

JAMES  BRONSON  REYNOLDS.  MISS  MABEL  T.  BOARDMAN. 

WM.  F.  DOWNEY.  MRS.  THOMAS  T.  GAFF. 

WHITEFIELD  McKINLAY. 


25 


REPORT  OF  THE  COMMITTEE  ON  SOCIAL  BETTERMENT. 


Washington,  D.  C,  Decemher  7,  1908. 

The  committee  on  social  betterment  has  realized  throughout  its 
work  that  the  question  of  health  is  intimately  connected  with  the 
physical,  social,  and  moral  welfare  of  all  persons  whose  only  income 
is  the  product  of  their  daily  labor.  Health  is  the  chief  asset  of  the 
workingman,  and  no  greater  calamity  can  befall  him  than  when  his 
earning  capacity  is  impaired  or  arrested  by  reason  of  sickness  or 
disability.  It  means  in  many  instances  the  utter  j&nancial  ruin  of 
the  family  aijid  is  doubtless  one  of  the  most  potent  causes  of  poverty 
and  distress. 

Many  of  the  diseases  are  incident  to  occupations  and  environments, 
and  industrial  efficiency  and  earning  power  can  be  promoted  by 
appropriate  safeguard  and  adequate  protection  of  the  men,  women, 
and  children  engaged  in  gainful  occupations. 

It  has  been  the  aim  of  the  committee  to  emphasize  therefore  the 
causes  and  prevention  of  industrial  diseases  and  also  of  some  of  the 
principal  preventable  diseases,  like  tuberculosis,  pneumonia,  typhoid 
lever,  sexual  diseases,  etc. 

The  committee  has  also  studied  the  standards  of  living  in  1,217 
families;  of  these  476,  or  39  per  cent,  had  a  family  income  of  $500 
or  less  per  annum ;  169,  or  13  per  cent,  had  an  income  of  from  $500  to 
$600;  153,  or  12^  per  cent,  from  $600  to  $700;  153,  or  12^  per  cent, 
from  $700  to  $800;  89,  or  7  per  cent,  from  $800  to  $900;  93,  or  8  per 
cent,  from  $900  to  $1,000 ;  and  94,  or  8  per  cent,  had  an  annual  income 
of  over  $1,000. 

The  Insults  of  these  fairly  accurate  returns  concerning  income  and 
expenditures  and  general  standards  of  living  are  set  forth  in  a 
special  report  by  Mr.  G.  A.  Weber,  of  the  Bureau  of  Labor,  who  was 
appointed  statistician  to  supervise  the  work.  The  data  with  reference 
to  the  expenditures  for  rent,  food,  liquor,  tobacco,  sickness  and  death 
(including  expenditures  for  patent  medicines),  number  of  working 
hours,  wage-earners'  lunches,  insurance,  installment  purchases,  usury, 
etc.,  are  of  interest  and  importance. 

In  addition  to  presenting  such  topics  as  "  How  to  keep  well  and 
capacitated  for  work,"  the  committee  in  its  efforts  to  improve  the 
homes  and  better  the  lives  of  the  industrial  classes,  believes  that 
special  attention  should  be  given  to  the  question  "  How  to  live  well 
and  cheaply,"  and  for  this  purpose  invoked  the  aid  of  Dr.  C.  F. 
Langworthy,  expert  in  nutrition  of  the  United  States  Department  of 
Agriculture,  who  cheerfully  consented  to  prepare  a  special  article  on 
"  Good  food  at  reasonable  cost."  Miss  E.  W.  Cross,  of  the  department 
of  domestic  science  of  the  McKinley  Manual  Training  School,  has 

27 


28  EEPOETS   OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

worked  out  dietaries  and  menus  for  families  with  an  income  of  $1.50 
a  day  . 

Believing  that  a  survey  of  the  causes  which  lead  up  to  low  stand- 
ards of  living  would  not  be  complete  without  reference  to  the  alco- 
hol question,  the  tobacco  and  drug  habits,  the  great  nostrum  evil, 
and  the  usury  evil,  special  studies  have  been  made  of  these  subjects 
and  the  results,  with  suitable  recommendations,  will  be  found  in  our 
report.  Miss  Mabel  T.  Boardman  has  prepared  an  excellent  article  on 
recreation  and  inexpensive  amusements,  Mr.  James  Bronson  Eeynolds 
has  prepared  the  article  on  the  business  relations  of  wage-earners, 
and  Mr.  William  F.  Downey  has  written  the  article.  How  to  benefit 
the  poor  in  the  slums.  The  thanks  of  the  committee  are  also  due. to 
Dr.  Paul  B.  Johnson,  Mr.  K.  M.  Webster,  Prof.  H.  W.  Wiley,  and 
Dr.  Lyman  F.  Kebler  of  the  Bureau  of  Chemistry  for  valuable 
material  and  to  General  Sternberg  for  a  careful  revision  of  the 
manuscript. 

George  M.  Kober,  Chairman, 


PART  1 -INDUSTRIAL  HYGIENE. 


Chapter  I. 

INTRODUCTION. 

In  the  search  for  the  causes  and  prevention  of  diseases  the  interests 
of  the  wage-earners  have  not  been  neglected ;  indeed,  it  may  be  truly 
said  that  a  special  department  has  been  created,  known  as  industrial 
hygiene  or  social  medicine,  with  a  most  complete  and  satisfactory 
literature  of  its  own.  German  authors,  in  1897,  issued  a  volume  of 
over  1,200  pages,  and  English  authors,  under  the  editorship  of  Dr. 
Thomas  Oliver,  devoted  891  pages  to  "  Dangerous  Trades — the  His- 
torical, Social,  and  Legal  Aspects  of  Industrial  Occupations  as 
Affecting  Health."  The  writer,  during  his  visit  to  Berlin  in  Septem- 
ber, 1907,  met  Dr.  E.  J.  Neisser,  who  had  just  completed  an  "  Inter- 
national Review  of  Industrial  Hygiene,"  covering  a  volume  of  352 
printed  pages.  Doctor  Neisser  deplored  his  inability  to  present  a 
general  review  of  the  work  accomplished  in  the  United  States  for  the 
promotion  of  the  welfare  of  the  wage-earners,  since,  with  the  excep- 
tion of  the  reports  of  the  inspector  of  New  Jersey,  no  recent  data 
concerning  factory  sanitation  were  available  for  publication.  Realiz- 
ing the  importance  of  the  subject,  not  only  to  wage-earners,  but  to  all 
interested  in  the  conditions  under  which  our  fellow  men  and  women 
live  and  work,  an  effort  has  been  made  in  the  succeeding  pages  to 
supply  this  information. 

It  is,  indeed,  a  feeble  attempt  towards  amelioration  of  existing 
conditions,  when  compared  with  the  monumental  volumes  of  German 
and  English  authors.  The  writer  acknowledges  his  indebtedness  to 
Doctor  Neisser  for  the  inspiration  given  him  by  his  own  good  and 
unselfish  work,  and  also  to  all  authors  consulted  by  him,  and  to  whom 
credit  is  given  in  the  text. 

It  is  hoped  that  this  study  of  the  causes  of  sickness  and  the  means 
of  promoting  industrial  efficiency  and  earning  power,  will  fill  one  of 
the  obligations  which  the  committee  on  social  betterment  assumed  to 
discharge. 

A  pioneer  study  was  made  by  Professor  Ramazzini,  of  Padua,  as 
early  as  1700,  and  his  nlonograph  was  translated  into  English  in  1705, 
and  also  into  French  in  1777. 

In  1810  the  French  Government  issued  a  decree  relating  to  "  etab- 
lissements  dangereaux,  insalubres  et  incommodes,"  and  in  1815  the 
English  Parliament  instituted  a  commission  to  inquire  into  the  con- 
dition of  factories,  etc.  In  1822  Mr.  C.  Turner  Thackrah,  of  Leeds, 
wrote  a  monograph  "  On  the  Effects  of  the  Arts,  Trades,  and  Profes- 
sions, and  of  Civic  States  and  Habits  of  Living  on  Plealth  and  Lon- 
gevity." In  1833  and  1865  the  English  Parliament  again  appointed 
commissioners,  and  in  1839  the  "Academie  des  sciences  morales  et 

29 


30 


REPORTS  OF  THE  PRESIDENT  S  HOMES  COMMISSION. 


politiques  de  France,"  and  subsequently  Bavaria,  Prussia,  and  the 
German  Empire  directed  similar  investigations.  As  a  result  of  these 
efforts  and  numerous  independent  investigations,  it  is  known  to-day 
that  persons  habitually  engaged  in  hard  work,  especially  in  factories 
and  indoors,  present  a  greater  amount  of  sickness  and  higher  mor- 
tality than  persons  more  favorably  situated,  and  that  the  character  of 
the  occupations  influences  to  a  great  extent  not  only  the  average  expec- 
tation of  life,  but  also  the  prevalence  of  certain  diseases. 

It  is  known,  for  example,  that  bronchitis,  pneumonia,  and  tubercu- 
losis are  much  more  frequent  in  dust-inhaling  occupations,  and  that 
the  sharp  angular  particles  of  iron  and  stone  dust  are  more  liable  to 
produce  injury  of  the  respiratory  passages  than  coal,  flour,  grain,  and 
other  kinds  of  dust.  It  is  also  known  that  workers  in  lead,  mercury, 
arsenic,  phosphorus,  poisonous  dyes,  etc.,  suffer  especially  from  the 
injurious  effects,  and  that  other  occupations,  such  as  mining,  railroad- 
ing, and  those  which  necessitate  working  with  or  around  moving 
machinery  involve  special  danger  to  life  and  limb. 

For  these  reasons  workers  in  many  industries  need  special  protec- 
tion, and  in  order  to  render  this  efficient  it  must  be  provided  for  by 
the  enactment  and  enforcement  of  suitable  laws.  In  1833,  186^,  1867, 
and  1870,  England  enacted  the  so-called  "  factory  laws."  France 
provided  a  child-labor  law  in  1841  and  in  1874  a  more  satisfactory 
labor  code.  Germany  and  other  continental  governments  enacted 
suitable  legislation  between  1859  and  1886. 

According  to  Miss  S.  S.  T\niittelsey's  "  Essay  on  Massachusetts 
Labor  Legislation,"  child  labor  received  attention  in  Massachusetts  as 
early  as  1836.  The  first  law  as  regards  safety  and  sanitation  was 
enacted  in  that  State  in  1877,  since  which  time  all  the  States  and  Ter- 
ritories have  enacted  some  form  of  labor  or  factory  laws. 


OCCUPATIONS    AND    MORTALITY. 

According  to  the  United  States  census  for  1900,  of  360,739  males, 
10  years  of  age  and  over,  dying  in  the  United  States  during  the  census 
year,  278,147,  or  77  per  cent,  were  reported  as  having  a  gainful  occu- 
pation. Of  females  10  years  of  age  and  over,  there  were  324,075 
deaths  and  45,491,  or  14  per  cent,  were  reported  as  having  a  gainful 
occupation.  In  the  ag^egate  the  table  on  page  cclx  gives  informa- 
tion as  to  the  mortality  by  occupations  tor  5,575,745  males  and 
1,587,874  females. 

The  death  rates  by  occupation  groups  are  as  follows : 


Occupation. 


Males: 

All  occupations 

Professional 

Clerical  and  official 

Mercantile  and  trading 

Public  entertainment 

Personal  service,  police  and  military 

Laboring  and  servant 

Manufacturing  and  mechanical  industry 

Affriculture,  transportation,  and  other  outdoor  pursuits 

All  other  occupations 

Females: 

All  occupations 

Nurses  and  midwives 

9«ryantfl 


Population. 


,575,745 
203, 104 
424, 781 
493,994 
87,888 
149,164 
800,893 
,796,928 
,528,241 
90,662 

,587,874 

41,912 

403,801 


Deaths. 


88,815 

8,109 

6,716 

6,000 

1,350 

1,931 

16,168 

24,769 

24,196 


13,203 

397 

6,920 


Death  rate. 


1900.       1890 


16.0 
15.3 
13.5 
12.1 
15.4 
12.9 
20.2 
13.8 
15.8 
6.5 


9.5 
17.1 


13.8 
16.7 
9.8 
12.3 
14.5 
15.4 
22.6 
13.0 
12.1 


10.5 
11.2 
18.2 


BEPORTS   OF   THE  PBESIDENT^S  HOMES  COMMISSION.  31 

Each  of  the  eight  large  groups  of  occupations  is  subdivided,  and 
detailed  information  is  given  in  60  specified  groups  of  employment 
for  males,  and  in  14  groups  for  females,  of  which  we  have  produced 
only  2  for  females,  on  account  of  their  high  death  rate. 

Unfortunately  we  have  no  reliable  occupation  mortality  statistics, 
and  never  will  have  until  greater  attention  is  given  this  subject  by 
health  officials  and  the  Census  Bureau. 

In  view  of  the  importance  of  the  subject  and  the  tendency  else- 
where toward  a  more  detailed  classification  and  information  for  in- 
dustries and  trades,  Mr.  Frederick  L.  Hoffman  ^  says : 

It  was  reasonably  to  be  expected  that  the  census  report  of  1900  would 
materially  increase  the  number  of  specific  occupations  dealt  with  in  the  section 
discussing  the  relation  of  occupation  to  mortality,  but  instead  of  89  employ- 
ments discussed  in  the  census  of  1890  only  60  are  dealt  with  in  detail  in  the 
census  of  1900.  To  make  this  matter  worse,  the  details  are  not  given  in  the 
fundamental  tables,  but  a  vast  majority  of  heterogeneous  employments  are 
grouped  in  a  purely  arbitrary  manner,  filling  space  to  no  advantage,  and  re- 
sulting in  conclusions  of  no  practical  value. 

He  very  properly  objects  to  grouping  together  miners  and  quarry- 
men,  because  according  to  the  census  of  1890  the  comparative  mortal- 
ity figure  of  quarrymen  was  469,  while  that  for  minei:s  was  given  as 
1 ,127 ;  "  and  to  combine  two  such  unlike  occupations  is  the  mere  pro- 
duction of  a  figure  which  has  absolutely  no  determining  value,  but 
the  use  of  which  must  lead  to  false  and  mischievous  conclusions." 
For  like  reason  he  objects  to  the  grouping  together  of  fishermen, 
oystermen,  sailors,  and  pilots,  which  he  very  properly  regards  as 
three  well-defined  groups  of  employment.  The  mortality  figure  in 
the  census  of  1890  for  fishermen  and  oystermen  was  543;  for  pilots 
it  was  630,  and  for  sailors,  2,276.  Many  other  combinations  of  em- 
ployments, such  as  hotel  keepers  and  boarding-house  keepers,  or 
saloon  keepers  with  restaurant  keepers  are  objectionable,  as  it  does 
not  enable  the  student  of  social  questions  to  determine  the  effects  of 
alcohol  upon  longevity.  If,  for  example,  restaurant  keepers,  who 
very  generally  do  not  engage  in  the  liquor  traffic,  had  not  been  com- 
bined with  saloon  keepers,  bartenders,  etc.,  the  death  rate  of  this 
group  might  not  be  so  favorable  but  be  more  in  accordance  with  the 
excessive  mortality  rates  observed  in  this  class  in  other  countries. 
Mr.  Hoffman  points  out  that  during  the  five  years  1891-1895,  during 
a  condition  of  peace,  the  death  rate  of  the  United  States  army  was 
6.6  per  1,000,  and  for  the  navy  8.3  per  1,000,  and  concludes  from  this 
that  soldiers  and  sailors  should  not  have  been  combined.  We  quite 
agree  with  him,  as  there  is  reason  to  believe  that  the  factor  of 
environment,  such  as  close  sleeping  quarters  and  dampness,  influence 
the  life  of  sailors  adversely.  He  also  refers  to  a  number  of  mis- 
leading occupation  death  rates,  because  no  correction  is  made  for  the 
difference  in  age  distribution  in  widely  different  employments.  As  a 
result  "  the  published  rates  do  great  injustice  to  employments  en- 
tirely healthy,  while  giving  favorable  position  to  employments  the 
health  conditions  of  which  are  ^uite  the  opposite.  This  point  is 
readily  illustrated,  if  comparison  is  made  of  the  mortality  of  farmers 
and  printers,  the  former  of  which  according  to  the  census  experi- 

<»  Quarterly  Publication  of  the  American  Statistical  Association,  December, 
1902,  p.  172. 


32  EEPOBTS  OF  THE  PEESIDENt's  HOMES  COMMISSION. 

enced  a  mortality  '  at  all  ages '  of  17.6  per  1,000,  against  a  death  rate 
of  12.1  per  1,000  for  printers.  Hence,  apparenUy,  printers  enjoy 
a  much  lower  mortality  than  farmers.  Or  course  the  opposite  is 
the  case.  The  inaccuracy  of  the  rates  is  the  result  of  radical  differ- 
ences in  the  age  distribution  of  the  two  employments,  there  being 
11.6  per  cent  of  farmers  at  ages  65  and  over,  while  among  printers 
there  are  only  1.5  per  cent  living  at  this  age  period.  *  *  * 
When  proper  comparison  is  made,  the  mortality  in  farmers  is  consid- 
erably below  that  of  printers  at  all  periods  of  life." 

Mr.  Hoffman's  suggestions  for  improving  vital  statistics  are 
worthy  of  careful  consideration.  The  present  chief  statistician  of 
the  division  of  vital  statistics.  Doctor  Wilbur,  is  a  trained  physician, 
a  keen  student  of  social,  sanitary,  and  industrial  questions,  and  per- 
fectly familiar  with  the  literature  and  the  results  achieved  by  more 
accurate  and  scientific  methods  of  the  treatment  of  the  subject  else- 
where. We  may,  therefore,  confidently  expect  more  definite  data 
concerning  the  relative  danger  incident  to  various  occupations. 

MORBIDITY  AND  MORTALITY  OF  WAGE-EARNERS, 

The  statistics  of  the  morbidity  and  mortality  of  various  occupa- 
tions, while  far  from  satisfactory  and  subject  to  more  or  less  erro- 
neous conclusions,  nevertheless  indicate  that  persons  habitually  en- 
gaged in  hard  work  are  more  frequently  subject  to  disease  and  pre- 
sent a  higher  mortality  than  persons  more  favorably  situated;  and 
this  is  especially  true  of  factory  employees,  because  their  work  is 
generally  more  monotonous,  fatiguing,  performed  under  less  favor- 
able surroundings,  and  they  are  too  often  also  badly  nourished  and 
badly  housed. 

Rohe,  in  his  "  Text  Book  on  Hygiene,"  presents  a  table  of  a  large 
number  of  persons  in  the  State  of  Massachusetts  whose  occupations 
were  specified,  the  total  number  of  decedents  was  144,954;  the  aver- 
age age  at  death  was  50.9.  From  this  tabulation  it  appears  that 
farmers  and  gardeners  have  the  greatest  expectation  of  life,  with 
an  average  of  65.29  years: 

Active  mechanics:  Tears. 

Outdoors 56. 19 

Indoors 47.  57 

Inactive  mechanics  in  shops 43.87 

Professional  men 50.81 

Merchants,  financiers,  agents,  etc 48.95 

Laborerers  without  special  trades 47.41 

Factors,  laboring  abroad,  etc 36.29 

Employed  on  the  ocean 46.44 

Females  engaged  in  wage-earning  occupations , 39.13 

Among  the  occupations  usually  classed  as  inimical  to  health  are 
bleachers,  bookbinders,  brass  founders,  compositors,  coppersmiths, 
electrotypers,  stonecutters,  gas-works  employees,  white-lead  workers, 
match  workers,  persons  employed  in  the  manufacture  of  explosives, 
firemen,  potters,  file  makers,  and  rubber- factory  operatives. 

The  following  table  from  the  reports  of  the  Twelfth  Census  shows 
the  death  rates  per  1,000  for  leading  causes  and  for  all  causes  in 
certain  occupations  in  1900: 


BBPORTS   OF   THE  PRBSIDEITT  S  HOMES  COMMISSION. 


33 


Death  rate  per  1,000  employees  in  certain  occupations  in  registration  States  in 
1900,  hy  principal  causes  of  death. 


Death  rate  per 

1,000. 

Occupation. 

Tuber- 
culosis 

of 
lungs. 

Diseases 

of 
nervous 
system. 

Heart 
disease. 

Pneu- 
monia. 

Diseases 

of 
urinary 
organs. 

Acci- 
dents 
and  in- 
juries. 

All 
causes. 

MANUFACTURING  AND  MECHAN- 
ICAL INDUSTRIES. 

Bakers  and  confectioners 

Blacksmiths 

2.60 
2.12 
1.35 

2.56 

2.87 

3.59 
2.31 

4.76 

4.35 
2.99 

2.29 
2.36 
3.11 
2.27 
1.95 
5.40 
2.93 

2.07 
1.98 

3.19 

2.94 
2.18 
3.65 

2.61 

1.11 
1.20 
1.29 

1.60 
2.99 
1.50 

2.74 
2.30 

2.21 
2.45 

1.79 

1.30 
2.90 

2.08 
.91 
1.01 
2.67 
1.24 
1.10 
2.26 

.84 
4.47 

2.13 

.90 
1.43 
1.77 

.89 
2.70 

1.02 
1.90 
1.45 

2.22 
1.77 

1.61 
2.23 

1.75 

.93 
2.72 

1.80 
1.01 
1.26 
2.11 
1.03 
1.59 
2.32 

.90 
3.81 

1.69 

.59 
1.28 
1.26 

.96 
2.62 

1.17 

1.68 

.95 

2.40 
1.72 

1.73 
1.46 

2.15 

1.15 
2.09 

1.77 
1.81 
1.32 
.97 
1.10 
1.37 
2.30 

.80 
2.97 

1.54 

1.13 
1.13 
1.37 

1.47 

1.49 

.77 
.60 

1.45 
1.90 

.78 

2.56 
1.36 

1.67 
1.73 

1.68 

.93 
8.08 

1.66 

.77 
.84 

2.27 
.98 
.83 

1.83 

.57 
1.16 

1.82 

.88 
1.38 
1.31 

.90 

1.70 

0.61 

1.00 
.33 

1.37 
.81 

.64 
1.18 

.70 

.49 
1.36 

1.83 
.78 
.66 
.97 
.71 
.99 

1.67 

.75 
1.98 

1.28 

.76 
.51 
.91 

1.33 

12.8 
18.3 

Boot  and  shoe  makers 

9.4 

Brewers,  diatillers,  and  recti- 
fiers   

19.7 

Butchers 

16.1 

Cabinetmakers  and  upholster- 

18.0 

Carpenters  and  joiners 

Cigar    makers   and  -  tobacco 
workers 

17.2 
18.7 

Compositors,     printers,     and 

12.1 

Coopers 

28.  S 

Engineers  and  firemen  (not 

15  7 

Iron  and  steel  workers 

Leather  makers 

10.7 
12.3 

17.5 

Machinists 

10.5 

Marble  and  stone  cutters 

Masons  (brick  and  stone) 

Mill  and   factory  operatives 
(textiles) 

14.9 
19.9 

8.8 

Millers  (flour  and  grist) 

Painters,   glaziers,   and   var- 
nishers 

26.6 
16.2 

Plumbers,  and  gas  and  steam 
fitters 

9.1 

Tailors 

11.8 

Tinners  and  tinware  makers . . 

AGRICULTURE,  TRANSPORTA- 
TION, AND  OTHER  OUTDOOR. 

Draymen,    hackmen,     team- 
sters, etc 

14.6 
11.0 

Farmers,  planters,  and  farm 
laborers 

17.6 

Miners  and  quarrymen 

Steam  railroad  employees 

3.78 
4.10 

9.6 

.95 

.88 

.64 

10.8 

The  following  table  from  the  report  of  the  registrar-general  of 
England  and  Wales  shows  the  comparative  mortality  of  occupations 
in  England  and  Wales  1890-1892.  The  average  mortality  of  all 
males  of  the  population  between  25  and  65  years  of  age  was  placed 
at  1,000.  The  mortality  of  occupied  males  was  953  and  of  the  unoc- 
cupied 2,215.  The  comparative  mortality  of  the  different  groups  was 
as  follows: 


Occupation. 

Compara- 
tive mor- 
tality. 

Occupation. 

Compara- 
tive mor- 
tality. 

Clergymen,  priests,  ministers.. 

533 
553 
563 
604 
664 
783 
821 
845 
859 
966 
989 

Bricklayer,  mason,  builder 

1,001 

Gardener,  nurseryman 

Butcher 

1,096 

Printer 

1,096 

1,120 

Grocer,  etc 

Cotton  manufacturer,  Lancashire — 

1,176 

Carpenter,  joiner 

1,384 

Slater,  tiler 

1,823 

Fisherman 

Brewer .  .       

1,427 

Shopkeeper 

Innkeeper,  hotel  servant 

1,659 

Meoic&l  practitioner 

Potter,  earthenware  manufacturer... 
File  maker 

1,706 

Tailor 

1«810 

S.  Doc.  644,  60-2- 


34 


REPORTS   OF   THE  PRESIDENT'S   HOMES  COMMISSION 


A  reasonable  explanation  for  the  excessive  mortality  in  some  of  the 
occupations  will  be  found  in  subsequent  pages;  the  high  rates  in 
brewers,  innkeepers,  and  hotel  servants  are  believed  to  be  due  to  the 
effects  of  alcohol. 

According  to  Rauchberg^  the  average  number  per  1,000  members 
of  the  "  Vienna  Sick  Benefit  Society  "  taken  sick  during  a  period  of 
seventeen  years  was  423  per  annum,  distributed  as  follows: 


Occupation, 

Average 
number 

taken  sick 
per  1,000 

members. 

Occupation. 

Average 
number 

taken  sick 
per  1,000 

members. 

Assistant  machinists 

488 
477 
473 
451 
437 
378 
367 
354 

Ironworkers 

351 

Factory  employees  and  day  laborers. . 

Shoemakers ... 

343 

Foundrymen 

Tinners  and  bronzers 

339 

Blacksmiths     

Cabinetmakers  and  wood  workers... 
Saddlers  

326 

JMasons  and  stonecutters 

285 

Painters 

Tailors  and  furriers 

215 

Weavers  and  spinners 

462 

Locksmiths 

Industrial  diseases  and  industrial  accidents  are  ever^^where  assum- 
ing more  and  more  importance,  and  our  knowledge  should  be  based 
upon  accurate  data.  In  countries  like  England,  where  reports  of  cer- 
tain occupations  are  compulsory,  it  is  quite  possible  to  secure,  for 
example,  reliable  data  as  to  the  number  of  cases  of  lead  poisoning. 
The  same  may  be  said  of  the  facilities  afforded  by  the  statistics  of  the 
"  German  Industrial  Insurance  Institutes,"  which  furnish  not  only 
the  number  of  deaths,  but  also  the  number  of  cases  treated,  together 
with  the  age  period  and  the  duration  of  the  disease.  Similar  facts 
should  be  collected  in  this  country.  This  is  all  the  more  important 
when  it  is  remembered  that  even  with  the  most  complete  statistics, 
it  is  extremely  difficult  to  determine  all  the  factors  which  influence 
the  health  and  longevity  of  operatives.  Great  differences  are  found 
in  the  conditions  under  which  the  work  is  performed,  some  of  which 
are  entirely  avoidable,  while  others  are  not,  and  it  is  hardly  fair  to 
characterize  certain  trades  as  dangerous  when  experience  has  shown 
that  no  harm  results  when  proper  safeguards  have  been  taken.  In 
the  consideration  of  this  question  the  personal  element  of  the  work- 
men, their  habits,  mode  of  life,  food,  home  environments,  etc.,  can 
not  be  ignored.  There  are  a  number  of  occupations  in  which  the 
alcohol  habit  prevails  to  an  unusual  extent,  perhaps  because  of  the 
character  of  the  work,  perhaps  as  a  result  of  association,  and  it  would 
not  be  fair  to  attribute  the  ill  health  of  the  operatives  altogether  to 
the  character  of  the  employment.  Again,  many  persons  are  engaged 
in  occupations  for  which  they  are  not  physically  fitted,  while  others 
ruin  their  health  by  vice,  dissipation,  improper  food,  and  insanitary 
environments  at  home.  In  addition  to  all  this  there  are  factors,  such 
as  water  and  soil  pollution,  for  which  neither  the  industry  nor  the 
individuals  are  primarily  to  blame.  Thus,  for  example,  the  general 
ansema  of  the  agricultural  classes  in  Porto  Rico  was  attributed  a 
few  years  ago  to  their  occupation  and  starvation,  when  as  a  matter  of 
fact  it  was  caused  by  the  "  hook-worm  disease."    Recent  investiga- 

•  Die  allg.  Arbeiter-Kranken  und  Invalidencasse  in  Wien,  1886, 


REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  35 

tions  conducted  by  Doctor  Stiles  appear  to  indicate  that  the  same 
disease  prevails  to  some  extent  among  the  textile  operatives  in  the 
South.  All  this  indicates  the  need  of  a  thorough  study  of  the  condi- 
tions affecting  health  in  various  occupations,  not  only  to  determine 
the  relative  health  risks  and  the  causes  of  the  undue  prevalence  of 
certain  diseases  in  certain  occupations,  but  also  to  formulate  rules 
which  may  remove  the  causes  or  render  the  system  better  fitted  to 
resist  them.  In  this,  as  in  all  preventive  efforts,  a  hearty  cooperation 
of  the  parties  interested  is  absolutely  essential  for  the  attainment  of 
the  highest  measure  of  success.  In  this  instance  the  responsibility 
rests  with  the  State,  the  employer,  and  employees;  each  have  certain 
duties  to  perform,  and  the  help  of  all  is  essential  for  the  mitigation  of 
existing  evils. 

INDOOR  OCCUTJPATIONS. 

Indoor  employment,  broadly  speaking,  is  inimical  to  health,  while 
outdoor  work  in  a  pure  air  favors  health  and  longevity.  Without 
underrating  the  influence  of  insanitary  dwellings,  improper  and 
insufficient  food,  lack  of  recreation,  and  other  factors,  there  is  no 
doubt  that  one  of  the  chief  dangers  of  indoor  life  is  exposure  to  viti- 
ated air.  The  air  of  dwellings  and  workshops  is  never  as  pure  as 
the  outer  air,  because  it  is  polluted  by  the  products  of  respiration, 
combustion,  and  decomposition,  and  the  presence  of  individuals  also 
tends  to  vitiate  the  air  with  dust,  germs,  and  organic  matter  from 
the  skin,  mouth,  lungs,  and  soiled  clothing.  Unless  proper  provision 
is  made  for  the  dispersion  of  foul  air  and  the  introduction  of  pure 
air  there  is  much  reason  for  assuming  that  these  impurities  play  a 
more  or  less  important  role  in  what  has  been  designated  as  "  crowd 
poisoning,"  characterized  in  the  acute  form  by  symptoms  of  oppres- 
sion, headache,  dizziness,  and  faintness,  while  the  chronic  effects  of 
deficient  oxygenation  and  purification  of  the  blood  are  plainly  evinced 
by  the  pallor,  loss  of  appetite,  anaemia,  and  gradual  loss  of  physical 
and  mental  vigor.  All  of  these  effects  are  intensified  when  human 
or  animal  beings  are  obliged  to  occupy  rooms  with  an  air  supply  in- 
sufficient for  the  proper  oxygenation  of  the  blood,  and  as  a  result  of 
this  habitual  exposure  to  vitiated  air  we  note  an  undue  prevalence 
of  consumption  in  crowded  workshops,  dwellings,  prisons,  public  in- 
stitutions, and  formerly  also  in  military  barracks  and  battle  ships. 
Even  live  stock  shows  the  baneful  effects  of  insufficient  air  space,  for 
tuberculosis  among  the  range  cattle  of  the  far  west,  which  are  prac- 
tically without  shelter,  is  comparatively  rare,  while  it  affects  from 
15  to  25  per  cent  of  dairy  herds,  which  are  housed,  but  without  suffi- 
cient regard  to  light  and  air.  Improved  ventilation  and  increased 
air  space  have  everywhere  lessened  the  death  rate,  and  it  is  chiefly  by 
just  such  measures  that  the  rate  from  consumption  has  been  reduced 
from  11.9  to  1.2  per  1,000  in  the  British  armies.  As  a  matter  of  fact, 
an  abundance  of  pure  air  has  been  found  the  most  important  factor 
in  the  treatment  of  tuberculosis,  because  it  promotes  oxygenation  of 
the  blood,  stimulates  the  appetite  and  nutrition,  and  thereby  increases 
the  general  resisting  power  of  the  system. 


36 


REPORTS  OF   THE  PRESIDENT  S  HOMES  COMMISSION, 


Chapter  II. 

OCCUPATIONS   INVOLVING   EXPOSURE  TO   IRRITATING   DUST. 

It  has  long  been  known  that  dust-inhaling  occupations  predispos^e 
to  diseases  of  the  respiratory  passages,  which  may  result  in  consump- 
tion. The  particles  of  mineral  dust  produce  an  irritation  of  the 
mucous  membrane  of  the  nose,  throat,  respiratory  organs,  and  eyes, 
and  the  hard,  sharp,  and  angular  particles  of  iron  and  stone  dust  may 
cause  actual  abrasions.  According  to  Arnold'*  the  dust  which  is 
inhaled  lodges  on  the  mucous  membrane  of  the  air  passages  and  vesi- 
cles of  the  lungs,  there  to  be  coughed  up,  although  some  of  the  finest 
particles  are  taken  up  by  the  epithelial  cells  and  white  corpuscles  and 
carried  to  the  nearest  lymphatic  glands.  The  coarser  particles,  such 
as  iron,  stone,  or  coal  dust,  usually  lodge  upon  the  surface,  to  be 
coughed  up  with  the  secretions.  If  not  expectorated  they  will  cause 
harm  by  clogging  up  the  air  vesicles  and  interfere  with  respiration. 
In  the  meantime  not  infrequently  an  irritation  is  set  up,  causing 
catarrhal  conditions  of  the  mucous  membrane,  or  a  more  serious 
chronic  inflammation  of  the  respiratory  organs,  so  common  among 
persons  engaged  in  dusty  occupations.  The  chronic  inflammatory 
conditions  thus  produced  favor  infection  with  the  tubercle  bacillus. 
At  all  events,  Hirt's  statistics  show  that  men  employed  in  dust-pro- 
ducing occupations  suffer  much  more  frequently  from  pneumonia 
and  consumption  than  those  not  exposed  to  dust  and  that  there  is 
practically  no  difference  in  frequency  of  disease  of  the  digestive  sys- 
tem. The  relative  frequency  of  these  diseases  per  100  workmen  is 
as  follows:* 

Cases  of  Consumption,  Pneumonia,  a/nd  Digestive  Disorders  per  100  workers 

in  certain  occupations. 


Workers  in— 


Con- 
sump- 


Pneu- 
monia. 


Digest- 
ive dis- 
orders. 


Metallic  dust.... 
Mineral  dust  — 

Mixed  dust 

Animal  dust 

Vegetable  dust.. 
Nonduflty  trades 


28.0 
25.2 
22.6 
20.8 
13.3 
11.1 


17.4 
5.9 
6.0 
7.7 
9.4 
4.6 


17.8 
16.6 
15.2 
20.2 
15.7 
16.0 


Perlen  in  his  "  Inaugural  Dissertation,"  Munich,  1887,*'  discussed 
the  records  of  the  Munich  Polyclinic,  where  65,766  persons  were 
treated  between  1865  and  1885,  including  4,177  tuberculosis  patients, 
viz,  2,801  males,  1,263  females,  and  83  children.  Of  these,  1,425 
patients  had  been  engaged  in  occupations  where  they  were  exposed 
to  dust,  as  follows: 


«  Untersuchungen  (Iber  Staubinhalatlon,  etc.,  Leipzig,  188.5. 
•Cited  by  Harrington,  Practical  Hygiene,  1902,  p.  678. 
•Cited  by  Uffelmann,  Handbuch  d.  Hygiene,  18U0,  p.  587. 


KEPOBTS   OP   THE  PEESIDENT  S  HOMES  COMMISSION. 


37 


Occupations  exposed  to —  Percent. 

Metallic   dnst 30 

Vegetable  dust ■ 26 

Mineral  dust 18 

Mixed  dust 17 

Animal  dust 8 

According  to  the  reports  of  the  census  of  1900  the  consumption 
death  rate  of  marble  and  stone  cutters  in  the  United  States  is  six  times 
that  of  bankers,  brokers,  and  officials  of  companies,  and  the  mortality 
■in  61  other  employments  ranges  between  these  extremes. 

The  amount  of  dust  is  perhaps  less  important  than  the  character  of 
the  particles  which  compose  it.  The  susceptibility  to  consumption  in 
metal  workers  and  stonecutters  can  only  be  explained  by  the  fact  that 
the  hard,  sharp,  and  irregular  particles  of  this  kind  of  dust  are  more 
apt  to  produce  injury  of  the  mucous  membranes  of  the  respiratory 
tract.  But  it  is  not  fair  to  assume  that  the  less  irritating  dust  is  free 
from  danger,  for  as  pointed  out  by  E.  Eoth  <»  even  the  inhalation  of 
plaster  of  Paris  or  flour  dust  can  not  be  regarded  with  indifference, 
especially  when  it  is  preventable. 

Ahrens  ^  found  the  amount  of  dust  for  each  cubic  meter  of  air  in 
certain  industrial  establishments  as  follows: 

Mg.  Mg. 

Horsehair  works 10.0     Flour  mill 28.0 

Sawmill 17.0     Foundry 28.0 

Woolen  factory 20.0     Polishing  room  of  foundry 71.7 

Woolen  factory  with  exhauster-  7.0     Felt-shoe  factory 175.0 

Paper  factory 24.0     Cement  works 224.0 

Laboratory 1.4 


Paper-factory  employees 343 

Mechanical  industrial  shops 419 

Wood  turners 427 

Laborers  in  the  rag  storeroom  of 
a  paper  factory 429 


According  to  Schuler  and  Burkhardt,  cited  by  Roth,  the  morbidity 
among  1,000  workmen  engaged  in  dusty  occupations,  is  as  follows: 

Bookbinders 98 

Silk  weavers 205 

Cotton  spinners 235 

Printers 250 

Cotton  weavers 285 

Type  founders  and  typesetters 304 

According  to  Sommerfeld,  cited  by  Roth,  the  mortality  in  Berlin 
of  persons  engaged  in  nondusty  occupations  is  2.39  per  1,000 ;  of  per- 
sons engaged  in  dusty  occupations  is  5.42  per  1,000 ;  the  mortality  of 
the  Berlin  population  at  the  same  ages  is  4.93  per  1,000. 

Of  1,000  deaths  the  number  of  deaths  from  consumption  in  occu- 
pations without  development  of  dust  was  381;  in  occupations  with 
development  of  dust  it  was  480 ;  in  the  Berlin  population  at  the  same 
ages,  332.3. 

*•  METALLIC   AND   MINERAL   DUST. 

It  will  be  readily  understood  that  in  the  cutlery  and  tool  industry, 
especially  in  the  grinding  and  polishing  departments,  more  or  less 
dust  is  evolved  not  only  from  the  metallic  surfaces,  but  also  from  the 
numerous  grindstones  and  emery  and  corundum  wheels.  This  dust 
production  is  not  wholly  avoidable,  even  when  the  wet  process  is  em- 


oKompendium  der  Gewerbekrankheiten,  Berlin,  1904,  p.  106. 
» Archiv  fiir  Hygiene,  1894,  Heft  2. 


38  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

ployed.  It  is  known  that  occupations  involving  the  inhalation  of  this 
dust  tend  to  produce  diseases  of  the  lungs,  such  as  bronchitis,  peri- 
bronchitis, and  fibroid  pneumonia,  but  tuberculosis,  is  also  spoken  of 
by  the  workmen  as  "  grinders  asthma  "  and  "  grinders  rot,"  leads  the 
list. 

Moritz  and  Roepke"  have  shown  that  72.5  per  cent  of  the  deaths 
among  the  metal  grinders  of  Solingen  are  due  to  consumption,  as 
compared  with  35.5  per  cent  among  the  general  population. 

The  death  returns  for  twelve  years  of  the  city  of  Northampton, 
Mass.,  one  of  the  centers  of  the  cutlery  and  tool  industry,  show  that 
among  "grinders,"  "polishers,"  and  "cutlers"  diseases  of  the  lungs 
were  responsible  for  72.73  per  cent  of  the  mortality,  inclusive  of  54.5 
per  cent  of  deaths  from  tuberculosis.^ 

Hirt  gives  the  percentage  of  consumption  in  the  total  number  of 
sick  among  different  classes  of  workers  in  metal  as  follows:  Needle 
polishers,  60.6  per  cent;  file  cutters,  who  are  also  exposed  to  inhala- 
tion of  lead,  62.2  per  cent;  grinders,  40  per  cent;  nail  cutters,  12  per 
cent. 

Greenhow  ^  over  fifty  years  ago  called  attention  to  the  excessive 
mortality  among  the  needle  polishers  of  Sheffield.  Beyer  <^  found 
that  of  196  needle  polishers  at  Remscheid  only  24  were  over  40  years 
of  age.  The  reason  why  this  occupation  is  especially  dangerous  is 
because  the  "  wet  process  "  can  not  be  employed  for  small  objects, 
which  moreover  have  to  be  brought  more  closely  to  the  eyes,  and  thus 
the  chances  for  the  inhalation  of  this  metallic  dust  are  increased. 

The  danger  in  all  such  establishments  can  be  reduced  to  a  minimum 
by  the  employment  of  respirators  and  forced  ventilation  to  carry  the 
dust  away  from  the  operator.  The  Massachusetts  report,  cited  above, 
states  that  "  even  when  employers  have  provided  hoods,  connected 
with  a  system  of  exhaust  fans  or  blowers,  a  very  large  proportion  of 
grinders  recklessly  remove  the  hoods,  and  thus  expose  themselves 
unnecessarily  to  this  especially  dangerous  form  of  dust.  They  assert 
that  they  prefer  freedom  of  movement,  with  dust,  to  the  protection 
offered  by  hoods." 

Stonecutting  is  regarded  as  a  dangerous  occupation,  and  con- 
sumption is  quite  common  among  men  engaged  in  the  industry.  Those 
who  have  witnessed  the  various  operations  realize  that  in  spite  of  wet 
processes,  and  employment  in  the  open  air,  the  workmen  are  exposed 
to  a  great  amount  of  this  irritating  form  of  dust,  especially  those 
who  operate  the  pneumatic  tools. 

A  collective  investigation  published  in  1901,  and  cited  by  Roth,« 
shows  that  of  every  100  deaths  among  stonecutters,  polishers,  and 
quarrymen  86  were  due  to  diseases  of  the  lungs,  inclusive  of  55  deaths 
from  consumption.  Of  2,013  stonecutters  examined  by  Sommerfield, 
19.7  per  cent  were  afflicted  with  consumption;  17.98  per  cent  with 
other  diseases  of  the  lungs,  and  nearly  all  had  a  chronic  catarrh  of  the 
throat  or  larynx. 

o  Cited  by  Roth,  p.  26. 

b  Report  of  the  state  board  of  health  of  Massachusetts  upon  the  sanitary 
condition  of  factories,  worl^shops,  etc.,  1907,  p.  87. 

'^  Cited  by  Sander,  Handbuch  der  oeffentl.  Gesundheitspflege,  18S5,  p.  106. 
<*  Beyer,  Die  Fabrilrindustrie  des  Reg.  B.  Duesseldorf,  1876. 
•  Kompendium  der  Gewerbekrankheiten,  Berlin,  1904,  p.  108. 


REPORTS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  39 

According  to  the  report  of  the  board  of  health  of  Massachusetts, 
previously  cited,*  of  343  deaths  which  occurred  in  the  city  of  Quincy, 
Mass.,  among  stonecutters  during  a  period  of  about  sixteen  years,  41.4 
per  cent  were  due  to  pulmonary  consumption;  12  per  cent  to  other 
diseases  of  the  lungs ;  12.8  per  cent  to  diseases  of  the  heart ;  7  per  cent 
to  violence;  and  26.8  per  cent  to  all  other  causes. 

Mr.  Frederick  S.  Crum^  calls  attention  to  the  excessive  average 
mortality  rate  from  consumption,  205.4,  in  Barre,  Vt.,  which  he  attrib- 
utes to  the  stonecutting  industry. 

Millstone  and  slate  cutting  are  also  regarded  as  dangerous  occupa- 
tions. Persons  engaged  in  glass  cutting  and  polishing  are  not  only 
exposed  to  the  inhalation  of  a  sharp  and  irritating  dust,  but  also  to 
lead  poisoning  from  the  use  of  putty  powder,  which  contains  70  per 
cent  of  lead  oxide.  In  glass  establishments  in  Massachusetts,  where 
all  the  cutting  and  polishing  is  done  by  the  wet  method,  no  dust  is 
perceptible,  and  the  employees  as  a  class  appear  to  enjoy  good  health. 
Gem  finishers  also  have  a  high  consumption  and  sick  rate.  Workers 
in  mica  dust  and  bronzing  powders  used  in  the  manufacture  of  wall 
papers,  fancy  souvenir  cards,  moldings,  frames,  etc.,  are  predisposed 
to  diseases  of  the  respiratory  passages,  and  the  bronze  powder  in 
addition  is  liable  to  produce  headache,  loss  of  appetite,  nausea,  vomit- 
ing, and  diarrhea. 

It  is  said  of  the  bronzing  department  of  some  of  the  lithographing 
establishments  in  Massachusetts  that  in  spite  of  the  exhaust  ventila- 
tion the  air  is  heavy  with  bronze  dust  most  of  the  time.^'  "  The  boys 
who  run  the  fine  bronzing  machines  wear  handkerchiefs  over  the  nose 
and  mouth.  They  look  pale  and  unhealthy,  and  all  show  the  charac- 
teristic green  perspiration  due  to  contact  with  bronze.  The  great 
majority  of  the  employees  appear  to  be  healthy." 

In  the  manufacture  of  machinery  and  metal  supplies  some  of  the 
operations  involve  exposure  to  dust,  fumes,  vapors,  or  extreme  heat. 
In  some  of  the  processes,  where  emery  wheels  and  revolving  wire 
brushes  are  used,  enormous  amounts  of  fine  steel  and  emery  dust  are 
given  off,  unless  equipped  with  exhaust  ventilating  appliances.  In 
a  Massachusetts  investigation  covering  24  establishments  the  air  of 
some  of  the  rooms  was  found  exceedingly  dusty  and  about  one-tenth 
of  the  occupants  looked  pale  and  sickly,  and  complained  of  the  irri- 
tation of  the  air  passages  by  the  dust.  The  number  of  employees  in 
these  establishments  ranges  between  12,500  and  15,000.  Some  of  the 
establishments  were  models  in  character  as  regards  light,  ventilation, 
and  general  sanitation.  "  The  tumblers  and  emery  wheels  are  pro- 
vided with  hoods  and  blowers  which  are  effective  and  there  is  practi- 
cally no  dust.  The  rooms  in  which  castings  are  dipped  are  properly 
ventilated  and  all  fumes  are  effectively  removed.  All  of  the  machin- 
erj^is  well  protected." 

One  brass  foundry  was  reported  where  the  air  was  heavy  with 
fumes,  especially  in  winter,  no  mechanical  ventilation  being  installed, 
and  in  which  the  workmen  have  occasional  attacks  of  "  brass  foun- 

oPage  79. 

*  Quarterly  Publication  of  American  Statistical  Association,  December,  1907, 
p.  465. 

«  Report  of  the  State  Board  of  Health  of  Massachusetts  upon  the  sanitary  con- 
dition of  factories,  workshops,  etc.,  1907,  p.  SO. 


40  EBPOETS  OP   THE  PRESIDENT'S  HOMES  COMMISSION. 

ders'  ague."  The  following  may  be  taken  as  a  fair  statement  of  the 
hygienic  aspects  of  the  machinery  and  metal  industry:  "While  the 
nature  of  some  of  the  processes  is  such  as  to  warrant  classification 
of  this  industry  with  the  dangerous  trades,  the  conditions  under 
which  the  work  is  done  are  very  largely  responsible  for  the  injurious 
effects  on  the  health  of  the  employees,  and  these  conditions  are  to  a 
considerable  extent  avoidable  or  at  least  susceptible  of  improvement." 

The  same  Massachusetts  investigation  covered  14  iron  and  steel 
foundries  and  9  stove  foundries.  In  one  establishment,  the  depart- 
ment in  which  the  castings  are  sand  blasted  was  found  very  objec- 
tionable, as  the  air  was  heavily  impregnated  with  flying  sand,  which 
"  gets  into  the  mouth,  nose,  and  eyes,  and  the  employees  suffer  con- 
siderably from  soreness  of  the  last-mentioned  organs."  In  another 
establishment  this  condition  is  very  much  ameliorated  by  a  large 
flaring  hood  in  the  center  of  the  room  with  upward-suction  draft, 
the  operatives  wearing  helmets  with  fine  wire  inserts  to  protect  the 
eyes,  and  cloths  underneath  the  helmets  to  protect  the  nose  and  mouth. 
Iq  one  of  the  stove  foundries  "  the  dust  from  the  polishing  and  buff- 
ing process,  in  the  absence  of  hoods  and  exhaust  ventilation,  is  so 
thick  that  objects  a  few  feet  distant  can  not  clearly  be  made  out. 
Many  men  refuse  to  work  in  this  establishment  in  the  hot  months 
on  account  of  the  excessive  heat  and  general  discomfort.  In  some 
instances,  however,  where  the  necessary  protection  is  afforded  by 
the  employer,  the  men  habitually  remove  the  hoods  and  become  cov- 
ered with  emery  and  iron  particles." 

In  the  crushing,  grinding,  and  sifting  process  incident  to  the  manu- 
facture of  emery,  corundum,  and  sandpaper  more  or  less  fine  dust  is 
given  off  in  spite  of  the  fact  that  the  machines  are  more  or  less  com- 
pletely inclosed.  The  emery  and  corundum  industry  must  be  classed 
among  the  trades  intrinsically  dangerous  to  health,  on  account  of  the 
peculiarly  irritating  character  of  dust.  But  as  is  the  case  with  other 
dusty  occupations,  few  of  those  employed  can  be  induced  to  wear 
respirators. 

Coal  miners,  charcoal  men,  firemen,  chimney  sweeps,  etc.,  are  ex- 
posed to  constant  inhalation  of  coal  dust  and  soot,  and  though  subject 
to  chronic  bronchial  catarrh,  consumption  is  not  especially  common 
among  them. 

VEGETABLE  DUST. 

Millers  and  bakers  inhale  flour  dust,  and  according  to  Hirt  20.3 
per  cent  of  all  the  diseases  in  millers  are  pneumonia,  9.3  per  cent 
bronchial  catarrh,  10.9  per  cent  consumption,  and  1.9  per  cent  emphy- 
sema (abnormal  collection  of  air  in  the  lungs).  The  tuberculosis 
death  rate  according  to  Schuler  among  millers  in  Switzerland  is  3.75, 
as  compared  with  2.95  per  1,000  in  the  general  population.  Carpen- 
ters, joiners,  cabinetmakers,  etc.,  are  exposed  to  wood  dust,  and  the 
dust  from  hard  wood  is  probably  more  injurious  than  that  from 
softer  kinds.  Dr.  E.  J.  Neisser«  refers  to  a  wooden-tool  factory  at 
Strassburg  which  in  1904  furnished  15  cases  of  sickness  out  of  the  20 
employees,  with  two  hundred  and  eighty-eight  days  loss  of  work, 
distributed  as  follows :  Diseases  of  the  eyes,  1 ;  of  nose,  1 ;  throat,  2 ; 
and  diseases  of  the  lungs,  6.     The  Massachusetts  board  of  health 

o  Internatlpmil*  Ueberglcht  ueber  Gewerbehygiene,  Berlin,  190T. 


KEPOKTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  41 

fodnd  that  in  the  agricultural  tool  and  implement  industry  a  hard 
wood  called  "  coca-bola,"  which  is  used  for  tool  handles,  evolves  a 
very  pungent  and  irritating  dust,  productive  of  inflammation  of  the 
eyes  and  skin.  Some  persons  in  tne  course  of  a  week  or  two  become 
accustomed  to  its  effects,  while  others  are  obliged  to  discontinue 
work  in  the  department.** 

The  medical  inspector  of  Great  Britain,  according  to  Neisser, 
reported  a  number  of  toxic  symptoms  which  occurred  among  persons 
engaged  in  the  manufacture  of  weaver  shuttles  made  from  African 
boxwood.  Investigation  revealed  the  presence  of  an  alkaloid  in  the 
wood,  which  acted  as  a  heart  depressant,  producing  a  slow  and  inter- 
mittent pulse ;  headache,  drowsiness,  watering  of  the  eyes  and  nose, 
difficulty  in  breathing,  nausea,  and  weakness. 

Laborers  in  ^rain  elevators  and  grain  thrashers  inhale  a  very  irri- 
tating dust,  which  may  cause  acute  and  chronic  catarrh  of  the  mucous 
membranes.  Workers  in  tobacco  suffer  more  or  less  from  nasal, 
conjunctival,  and  bronchial  catarrh  and  digestive  and  nervous  de- 
rangements, and  although  the  mucous  membranes  gradually  become 
accustomed  to  the  irritation  of  the  dust  and  fumes,  the  occupation 
appears  to  be  dangerous,  as  the  consumption  rate  ranks  next  to  that 
of  stonecutters. 

It  is  said  that  female  workers  in  tobacco  are  more  liable  to  mis- 
carry; at  all  events  Doctor  Rosenfeld,  cited  by  Roth  (p.  166),  found 
this  to  be  true  in  Austria.  Dr.  E.  R.  Tracy,  of  New  York,  reports 
that  325  cigar  makers'  families  visited  by  him  had  only  465  children, 
an  average  of  1.43  to  each  family,  and  feels  disposed  to  attribute  this 
to  the  frequent  abortions  among  the  female  operatives.  This  experi- 
ence is  not  confirmed  by  recent  observations  made  in  German  tobacco 
towns  like  Giessen,  for  example  (Neisser,  p.  125),  and  more  extended 
investigations  are  called  for.  Some  authors  maintain  that  tobacco 
dust  exerts  a  protective  influence  against  infective  agents,  and  instance 
the  fact  that  during  the  cholera  epidemic  of  Hamburg  in  1892  there 
were  only  8  cases  among  the  5,000  resident  cigar  makers.  The  Massa- 
chusetts report  previously  cited,  in  discussing  the  cigar  and  cigarette 
factories  in  Massachusetts,  refers  (p.  49)  to  the  spitting  habit  and  the 
objectionable  practice  of  finishing  cigars  with  the  aid  of  saliva.  This 
practice  was  observed  in  more  than  one-third  of  the  places  visited, 
and  in  18  factories  the  practice  of  biting  off  the  end  of  the  filler  and 
inner  wrappers  with  the  teeth  was  also  observed.  The  report  reiter- 
ates the  statement  made  to  the  legislature  in  January,  1905,  as  to  the 
possibility  of  disseminating  loathsome  diseases  through  this  practice. 
Such  conditions  certainly  emphasize  the  necessity  for  the  use  of  cigar 
holders. 

TEXTILE  INDUSTRIES. 

Operatives  in  cotton  and  flax  textiles  are  perhaps  more  subject  to 
dust  inhalation  and  various  diseases  of  the  respiratory  and  digestive 
organs  than  those  of  woolen  mills.  The  Census  Report  of  the  United 
States  for  1900  gives  the  death  rate  among  150,783  male  mill  and 
factory  operatives  (textiles)  as  8.1  per  1,000,  and  of  the  162,932 
female  operatives  as  4  per  1,000.     As  pointed  out  by  Mr.  F.  L.  Hoff- 

•  Report  of  the  State  Board  of  Health  of  Massachusetts  upon  the  sanitary 
condition  of  factories,  workshops,  etc.,  1907,  p.  89. 


42 


EBPOBTS  OF   THE  PRESIDENT  S  HOMES  COMMISSION. 


man,  it  would  have  been  exceedingly  interesting  to  learn  the  death 
rate  among  cotton,  linen,  wool,  and  silk  workers.  The  phthisis  death 
rate  in  1892  in  Belfast «  with  its  30,000  persons  engaged  in  the  linen 
industry  was  4.1  per  1,000,  against  1.4  for  the  whole  of  England  and 
Wales,  and  2.1  for  Ireland.  According  to  Schuler  and  Burkhardt, 
1,000  linen  spinners  furnish  annually  221.6  cases  of  sickness;  1,000 
weavers  202.7,  while  female  operatives  suffer  even  more,  the  sick  rate 
being  249.5  and  334.4  for  the  respective  occupations. 

Cases  of  sickness  per  1,000  emijloyces  among  spinners  and  weavers. 


Disease. 


Diseases  of  the  digestive  organs 

Diseases  of  the  respiratory  organs 

Diseases  of  the  motor  organs . 

Diseases  of  a  constitutional  character 


Cases  per 
1,000  spin- 
ners. 


58.7 
47.7 
29.6 
22.9 


Cases  per 

1,000 
weavers. 


103.4 

•  52.6 

21.2 

31.6 


Arlidge  ^  gives  a  table  showing  the  comparative  frequency  of  the 
most  important  diseases  in  the  case  of  739  weavers,  and  of  676  per- 
sons following  the  several  other  branches  of  the  cotton  industry,  such 
as  winders,  spinners,  reelers,  curlers,  mill  hands,  grinders,  etc.,  and 
who  for  convenience  sake  are  designated  by  him  as  machine-room 
workers.  The  figures  are  based  on  1,415  operatives  who  received 
treatment  as  in  and  out  patients  in  connection  with  the  Preston 
Hospital  during  a  period  of  six  years. 


Disease. 


Per  cent  of 
machine- 
room  work- 
ers treated 
for  speci- 
fied disease. 


Phthisis 

Dyspepsia 

Bronchitis 

Varicose  veins  and  ulcers 

Rheumatic  affections 

Uterine  disorders  and  displacements 

Neuralgia 

Throat  affections 

Renal  diseases 

Epilepsy 

Heart  diseases 

Debility 

Anemia 


11.90 
21.00 
31.30 
6.80 
11. 68 
8.43 
4.43 
2.51 
2.66 
8.40 
5.32 
9.17 
2.60 


It  will  be  observed  that  the  Swiss  and  English  statistics  both  reveal 
an  undue  prevalence  of  the  diseases  of  the  respiratory  and  digestive 
organs.  It  has  been  suggested  that  the  constrained  position  of  weavers 
is  to  a  large  extent  responsible  for  the  undue  prevalence  of  dyspepsia 
among  the  Swiss  weavers,  but  other  factors,  like  improj^er  food, 
indoor  life,  and  home  conditions  should  be  considered.  This  is  appar- 
ent from  the  fact  that  the  percentage  of  cases  of  dyspepsia  among  the 


«G.  H.  Ferris,  Journal  of  State  Medicine,  March,  1895. 
^  Arlidge.     "  The  Hygiene,  diseases,  and  mortality  of  occupations,' 
1892,  p.  361. 


London, 


BEPOBTS   OP   THE  PBESIDENT^S  HOMES  COMMISSION.  43 

English  weavers  is  smaller  than  among  machine-room  workers.  The 
constitutional  disorders  like  anaemia,  chlorosis,  neuralgia,  and  de- 
bility are  likewise  due  to  a  variety  of  causes,  chief  of  which  are 
vitiated  air,  resulting  from  defective  ventilation  of  the  workshops, 
overwork,  insufficient  or  improper  food,  and  insanitary  homes. 

Uterine  derangements  and  displacements  may  very  properly  be 
attributed  to  general  debility,  overwork,  and  long  standing  in  hot  and 
moist  workrooms,  and,  like  varicose  veins  and  ulcers  and  "  flat  feet," 
may  be  expected  to  develop  in  other  occupations  involving  long  stand- 
ing.    (See  occupations  involving  constrained  attitudes.) 

The  undue  prevalence  of  pulmonary  diseases  among  the  textile 
operators  can  be  accounted  for  by  a  number  of  factors,  such  as  the 
presence  of  very  fine  cotton  or  flax  dust  or  "  fly ;"  air  vitiated  by  the 
products  of  respiration  and  combustion,  the  presence  of  infectious 
germs  from  the  promiscuous  expectoration  habit ;  faulty  life  and  home 
surroundings.  Of  these  the  presence  of  "  fly  "  is  doubtless  a  very 
important  predisposing  factor,  since  it  is  generally  admitted  that  this 
dust  acts  as  an  irritant  to  the  repsiratory  passages,  and  sooner  or  later 
prepares  the  way  for  the  invasion  of  the  germs  of  tuberculosis,  pneu- 
monia, etc.  Coetsem  describes  the  so-called  byssinosis  or  "  pneumonic 
cotonneuse,"  but  it  is  by  no  means  settled  whether  in  these  cases  we 
have  to  deal  with  a  typical  occupation  disease,  or  with  a  specific  infec- 
tion, in  which  the  inhalation  oi  the  cotton  dust  simply  operates  as  a 
predisposing  cause.  It  is  very  probable,  however,  that  the  habitual 
inhalation  of  this  dust  may  produce  disease  of  the  lungs  not  necessarily 
tubercular. 

Arlidge  says: 

If  inhaled  longer,  it  reaches  the  bronchi,  and  sets  up  cough  with  white  mu- 
cous expectoration.  The  cough  will  be  for  years  chiefly  a  morning  phenomenon 
on  first  rising,  but  it  is  also  induced  upon  leaving  the  warm  workroom.  Fine 
fibers  of  cotton  are  found,  on  microscopical  examination,  in  the  sputum,  and  as 
these  make  their  way  into  the  pulmonary  tissue  they  set  up  morbid  action, 
resulting  in  increasing  density  of  it  on  the  one  hand  and  of  emphysematous 
expansion  on  the  other.  These  morbid  changes  are  accompanied  by  dyspnoea, 
wasting,  and  debility,  but  rarely  with  hemoptysis  [spitting  of  blood],  and 
together  constitute  a  group  of  symptoms  not  inappropriately  termed  "  industrial 
phthisis."  Morover,  intercurrent  diseases  of  the  lungs,  such  as  acute  bronchitis 
and  pneumonia,  often  arise  and  terminate  life,  and  true  tubercular  phthisis 
is  no  uncommon  cause  of  death. 

The  chief  requirements  for  the  amelioration  of  existing  conditions 
in  the  textile  industry  are  efficient  machines  for  the  prevention  and 
removal  of  dust.  The  utmost  care  should  be  taken  to  provide  the 
most  perfect  methods  so  far  devised  for  the  removal  of  dust  and  for 
proper  ventilation.  The  lighting  should  be  good,  both  for  day  and 
night  work,  giving  preference  to  electricity.  The  temperature  and 
huiAidity  of  the  rooms  should  be  regulated,  and  children  under  the 
age  of  14,  or  those  with  weak  chests,  should  not  be  employed  at  all  in 
the  cotton  mills. 

In  the  textile  industry  in  Massachusetts  analysis  of  the  death 
returns  during  the  year  1905  from  the  three  principal  "  mill  towns  " 
shows  that  although  tuberculosis  is  one  of  the  leading  causes  of  death 
among  mill  operatives  the  general  death  rate  of  this  class  was  by  no 
means  abnormally  high,  being,  respectively,  7,  8,  and  10  per  1,000. 
Tuberculosis  caused,  respectively,  32,  23.57,  and  21  per  cent  of  the 
deaths.    It  appears  also  that  the  general  death  rates  of  the  cities  whose 


44  REPORTS  OF   THE  PRESIDENT'S   HOMES  COMMISSION. 

population  includes  the  highest  percentage  of  the  textile  operatives 
compare  not  unfavorably  with  those  of  certain  other  cities  which  are 
engaged  in  other  kinds  of  manufacture  or  are  more  residential  in 
character,  in  spite  of  the  high  rate  of  infant  mortality  which  appears 
to  be  inseparably  connected  with  mill  populations  everywhere.'* 

A  source  of  danger  is  the  presence  of  infectious  dust  from  dried 
sputum  in  the  air  of  different  mill  rooms  on  account  of  the  indiscrimi- 
nate habit  of  spitting. 

The  report  also  includes  an  excellent  summary  of  the  results 
obtained  by  an  inspection  of  93  manufacturing  establishments  and  the 
conditions  found  in  a  certain  proportion  of  weave  and  spinning  rooms 
are  tabulated  as  follows:  (1)  Poor  light;  (2)  presence  of  carbon- 
dioxide  and  carbon-monoxide  in  the  air;  (3)  nonregulation  of  arti- 
ficial moisture  (a)  excess  of  moisture,  undue  heat  or  (b)  no  artificial 
moisture,  excessive  heat;  (4)  more  or  less  dust  ("  fly  "  dust  from  siz- 
ing, etc.) ;  (5)  lack  of  cleanliness;  (6)  lack  of  provision  for  a  plenti- 
ful supply  of  fresh  air.  In  the  majority  of  mills  the  toilet  and  wash 
rooms  were  found  to  be  beyond  criticism ;  but  in  not  a  few  "  the  im- 
perative need  of  improvement  as  regards  structure,  location,  ventila- 
tion, and  common  decency  "  are  pointed  out.  The  number  of  acci- 
dents in  textile  mills,  considering  the  large  number  of  fast-running 
machines,  is  not  large,  during  a  period  of  almost  five  years  at  the 
Pacific  Mills,  with  about  5,200  employees,  amounting  to  1,000  classified 
as  follows: 

Accidents  to  employees  of  the  Pacific  Mills,  Lawrence,  Mass.,  August  10,  1900, 

to  July  IS,  1905. 

Killed  outright 1 

Fatally  injured 1 

Seriously  injured   (broken  limbs  or  amputation  necessary) 86 

Slightly  injured 910 

Unclassified  (suffered  nervous  shock,  but  physically  uninjured) 2 

Total 1,000 

The  underlying  cause  of  injury  is  given  as  follows : 

Careless  manipulation 539 

Deliberate  carlessness  (taking  chances  of  being  injured,  such  as  cleaning 

machinery  while  running,  etc.) 164 

Inattention  to  surroundings 177 

Carelessness  of  fellow-workman 51 

Unforseen  liability 60 

Unclassified 9 

Total 1,000 

According  to  the  factory  inspector's  statistics  of  the  State  of  New 
York  (cited  by  Frederick  L.  Hoffman  «)  for  the  five  years  ending  with 
1905,  out  of  3,140  accidents  in  textile  industries,  36,  or  1.1  per  cent, 
were  fatal.  Of  the  total  number  of  accidents  82.5  per  cent  caused 
temporary  disablement  and  16.2  per  cent  permanent  disablement. 

In  3  mills  in  Massachusetts  devoted  to  the  manufacture  of  twine, 
cordage,  and  gunny  cloth  from  jute  and  hemp  some  of  the  workrooms 

«  Report  of  the  State  Board  of  Health  of  Massachusetts,  1907,  p.  16. 
*  Bulletin  Bureau  of  Labor  No.  78.    September,  1908. 


BEPOBTS   OP   THE  PRESIDENT'S  HOMES  COMMISSION.  45 

are  reported  to  be  exceedin^y  dusty  in  spite  of  mechanical  ventila- 
tion and  open  windows.  "  Many  of  the  oj)eratives  wear  thick  bunches 
of  fiber  over  mouth  and  nose  as  a  protection.  A  fairly  large  propor- 
tion of  the  operatives  show  the  effects  of  their  employment,  looking 
pale  and  sickly."  In  the  room  where  the  sisal  hemp  is  fed  into 
breakers  the  air  is  filled  with  dust.  "  In  one  of  the  establishments 
the  employees  in  all  departments  look  well  and  strong,  although  the 
air  in  some  parts  contained  considerable  dust."  « 

In  5  Massachusetts  carpet  and  rug  factories,  employing  about  6,000 
persons,  about  10  per  cent  of  whom  are  between  the  ages  of  14  and  16, 
the  largest  of  these  factories  shows  some  departments  in  which  poor 
light,  excessive  heat,  moisture,  and  dust  constitute  objectionable  con- 
ditions. In  one  room  there  was  ''  so  much  fine  cotton  dust  and  fiber 
in  the  air  that  it  is  with  difficulty  one  can  see  across.  This  dust  is 
very  irritating  to  the  nose  and  throat."  In  one  of  the  establishments 
the  children  are  described  as  very  small  and  poorly  developed  for 
their  age  "  to  be  allowed  to  work  ten  hours  and  twenty  minutes  for 
five  days  in  the  week."  In  another  factory  "  about  one-tenth  of  the 
employees  look  sickly."  The  smallest  factory  employs  5iOO  persons, 
"  has  good  light,  adequate  ventilation,  and  commendable  weave  rooms, 
and  the  employees  appear  to  be  in  good  health." 

One  of  the  shoddy  mills  examined  was  poorly  lighted,  inadequately 
ventilated,  dusty,  and  ill  kept;  the  other  was  light,  clean,  and  well 
ventilated.  "  Some  of  the  women  employed  appeared  to  be  in  poor 
physical  condition.  In  the  6  felt-cloth  factories  examined  the  work 
was  found  to  be  conducted  in  fairly  lighted  and,  apart  from  dust, 
adequately  ventilated  buildings.  In  each  there  was  more  or  less  dust, 
especially  in  the  picking  and  carding  rooms;  but  the  amount  was 
much  diminished  in  most  of  them  by  means  of  blower  fans." 

ANIMAL   DUST. 

Of  the  several  classes  of  dust,  that  from  wool  is  considered  to  be 
less  irritating  than  flax  or  cotton,  and  horn  is  believed  to  be  more 
irritating  than  bone.  The  conditions  found  in  some  of  the  woolen 
mills  in  Massachusetts  as  regards  light,  ventilation,  and  general 
cleanliness  are  reported  as  far  from  satisfactory;  but  in  the  absence 
of  morbidity  statistics  it  is  difficult  to  determine  the  degree  of  danger 
to  which  the  operatives  are  exposed.  In  the  boot  and  shoe  industry  in 
Massachusetts,  where  there  is  more  or  less  animal  dust  evolved,  some 
effort  is  being  made  to  remove  the  dust  by  exhaust  flues  attached  to  the 
machinery.  Of  the  373  factories  summarized  by  the  Massachusetts 
board  of  health  report  previously  cited,  "  126  are  partially,  and  a 
fair  proportion  of  these  are  wholly,  equipped  with  this  means  of  pro- 
tection ;  in  88  of  these  126  one  or  more  machines  are  not  so  equipped ; 
and  in  49  of  the  88  there  are  rooms  in  which  the  air,  apart  from  the 
escaping  dust,  is  noticeably  bad.  The  number  of  machines  with 
means  for  efficient  or  fairly  efficient  removal  of  dust  was  found  to  be 
1,630;  the  number  either  inefficiently  equipped  or  devoid  of  equip- 
ment was  reported  as  2,769.  *  *  *  While  in  general  the  health  of 
the  employees  appears  to  be  fair  to  good,  in  85  factories  a  considerable 

"Report  of  the  State  Board  of  Health  of  Massachusetts  upon  the  sanitary 
condition  of  factories,  workshops,  etc.,  1907,  p.  46, 


46  REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

proportion  of  them  are  noticeably  pale  and  unhealthy  in  appear- 
ance." The  pale  and  poorly  nourished  condition  of  youthful  em- 
ployees is  also  emphasized. 

The  dust  and  moisture  involved  in  the  polishing  departments  of 
the  horn  and  celluloid  industry,  and  the  irritating  fumes  given  off 
by  a  "dip  "  containing  glacial  acetic  acid,  are  sources  of  possible 
injurious  effects  to  the  employees. 

In  the  manufacture  of  derby  and  felt  hats,  apart  from  the  exposure 
to  dust  from  the  fur  which  comes  to  the  factory  clipped  from  the 
skin,  there  is  also  a  certain  degree  of  danger  from  cyanide  of  mercury, 
with  which  the  fur  is  treated.  In  4  felt-hat  factories  inspected  by 
the  Massachusetts  board  of  health,  "  the  employees  appeared  to  be 
healthy."  In  some  of  the  establishments  visited  the  fumes  of  wood 
alcohol  in  the  drying  department  were  markedly  strong.  "  The 
workmen  stated  that  they  are  frequently  troubled  with  headaches, 
vertigo,  smarting  and  burning  of  the  eyes,  and  impairment  of  vision, 
and  that  few  can  remain  at  this  work  longer  than  three  or  four 
months  at  a  time."  This  could  readily  be  prevented  by  the  use  of 
"  denature^  "  alcohol.  In  the  "  pouncing  process,"  which  consists  in 
smoothing  off  the  rough  hairs  from  the  hat  rim  and  other  parts,  "  a 
great  deal  of  very  fine  dust  is  given  off." 

Mr.  Frederick  S.  Crum  ^  gives  the  mortality  rate  from  consumption 
in  Orange,  N.  J.,  as  289.9,  as  compared  with  the  average  of  151.0  for 
the  200  small  cities  investigated  by  him,  and  attributes  this  excess  to 
the  fact  that  in  1905  there  were  1,379  employees  engaged  in  the  felt- 
hat  industry  in  Orange. 

In  the  brush-making  industry  hogs'  bristles  and  vegetable  fibers 
are  used.  In  seven  brush  factories  in  Massachusetts  "the  general 
conditions  were  found  to  be  beyond  criticism  and  the  health  of  the 
employees  appeared  to  be  fair  or  good." 

Hirt  regarded  brush  making  as  a  dangerous  occupation,  as  nearly 
one-half  of  the  deaths  among  the  brush  makers  were  from  consump- 
tion, due  probably  to  the  inhalation  of  the  sharp  fragments  of  bristles. 

There  are  no  adequate  reliable  data  as  to  effects  of  animal  dust 
given  off  in  the  manufacture  of  woolen  goods,  silk,  feather,  fur,  hair, 
horn,  bone,  shell,  ivory,  etc.  It  is  reasonable  to  assume,  however,  that 
the  dust  from  all  these  sources  is  capable  of  setting  up  an  irritation 
and  inflammation  of  the  respiratory  passages,  though  not  as  intensive 
as  that  caused  by  mineral  constituents  of  dust.  In  the  hair,  brush, 
and  wool  industry  there  is  also  some  danger  from  disease  germs. 


Chapter  III. 

OCCUPATIONS  INVOLVING  EXPOSURE  TO  INFECTIVE  MATTER  IN 

DUST.  I 

RAG,   PAPER,  WOOL,  AND   HAIR   INDUSTRY. 

It  has  been  held  for  a  long  time  that  germs  of  infectious  diseases 
like  smallpox,  anthrax,  scarlet  fever,  tuberculosis,  typhus  and  typhoid 
fever,  diphtheria,  measles,  and  cholera  may  cling  to  body  and  bed 

« Quarterly  Publication  of  the  American  Statistical  Association,  December, 
1907,  p.  464. 


BEPORTS   OF    THE  PRESIDENT'S  HOMES   COMMISSION.  47 

clothes  and  prove  a  source  of  danger  to  those  coming  in  contact  with 
rags  in  the  rag  business  and  paper  industry.*  The  danger,  while  per- 
haps overrated,  is  nevertheless  real  and  can  be  guarded  against  only 
by  a  thorough  disinfection  of  the  rags  by  steam  under  pressure  before 
they  are  handled  at  the  paper  mills. 

The  occupation  is  evidently  inimical  to  health.  Of  4,857  German 
operatives  reported  by  Uffelmann,  50  per  cent  are  annually  taken 
sick ;  about  34  per  cent  of  those  engaged  in  the  handling  of  dry  rags 
suffered  from  affections  of  the  respiratory  passages,  and  only  21.9 
per  cent  of  those  otherwise  engaged  in  the  same  establishments,  all 
of  which  speaks  strongly  for  the  necessity  of  proper  ventilation  and 
exhaust  flues  for  the  removal  of  dust. 

In  this  connection  it  is  proper  to  refer  to  the  dangers  of  the  so- 
called  "  rag  sorters'  "  and  "  wool  sorters'  "  disease,  which  are  nothing 
more  or  less  than  anthrax  infection — a  disease  transmissible  from 
animals  to  man  by  means  of  wool,  hides,  hair,  and  horsehair.  Two 
hundred  and  sixty-one  cases,  with  67  deaths,  were  reported,  according 
to  Neisser,  in  England  from  1899  to  1904.  Of  these,  88  occurred 
among  those  engaged  in  the  wool  industry,  70  cases  among  persons 
engaged  in  curled-hair  and  brush  factories,  86  in  persons  engaged  in 
tanneries  and  hide  trades,  and  17  in  other  industrial  pursuits. 

About  59  cases  of  anthrax  infection  were  reported  in  different  parts 
of  Europe  during  the  year  1905.  Ravenal  reported  in  three  localities 
in  Pennsylvania,  during  the  summer  of  1897, 12  cases  among  men  and 
60  in  cattle,  which  were  traced  to  a  tannery  handling  imported  hides 
from  China.  Nichols  reported  26  cases  occurring  in  persons  employed 
in  a  curled-hair  factory  within  three  years. 

The  General  Government  recognizes  the  dangers  by  insisting  upon 
the  exclusion  of  rags,  wool,  and  hides  coming  from  infected  districts 
during  the  prevalence  of  cholera,  anthrax,  and  typhus  fever  and 
their  proper  disinfection  at  all  times.  tVTiile  anthrax  is  not  a  very 
common  disease  among  American  domestic  animals,  local  pustular 
infections  and  carbuncle  are  by  no  means  infrequent,  and  might  well 
be  guarded  against,  as  in  some  of  the  European  countries,  where 
recourse  is  had  to  disinfection  of  the  raw  material,  special  blower 
apparatus  for  the  removal  of  dust,  repeated  disinfection  of  the 
premises,  and  prompt  treatment  of  all  slight  wounds  and  abrasions. 

The  material  from  which  paper  is  made  includes  rags,  burlap,  old 
paper,  and  wood  pulp.  The  rags  are  chiefly  imported  from  foreign 
countries,  arriving  in  a  baled  condition,  and  after  opening  are  sub- 
jected to  a  number  of  processes  for  the  purpose  of  cleaning  and  dis- 
integration. The  "beating,  thrashing,"  and  "chopping"  process  is 
carried  on  by  machines  and  is  attended  by  the  escape  of  more  or  less 
dust.  The  quantity  naturally  varies  with  the  cleanliness  of  the  stock. 
In  the  observations  of  about  80  establishments,  the  Massachusetts 
boara  of  health  found  that  with  the  usual  grade  of  stock,  no  matter 
what  kind  of  "  duster  "  or  "  thrasher  "  is  used,  a  considerable  amount 
of  dust  is  also  evolved  in  the  "  chopping "  process,  and  in  spite  of 
exhaust  fans  and  dust  pipes  some  dust  will  escape.  The  men  engaged 
in  the  collection  and  baling  of  this  dust  are  usually  provided  with 

"The  State  of  Maine  requires  evidence  of  successful  vaccinntion  in  persons 
engaged  in  the  rag  industry  or  those  employed  in  the  manufacture  of  paper 
from  foreign  and  domestic  rags. 


48  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

respirators.  In  a  majority  of  the  mills  visited  a  proportion  of  the 
employees  are  exposed  to  an  excessive  quantity  of  dirt,  dust,  and  lint, 
and  in  most  of  this  majority  the  persons  so  exposed  show  not  a  few 
who  are  pale  and  sickly  in  appearance.  A  comparison  of  the  death 
rate  from  tuberculosis,  pneumonia,  and  bronchitis  at  Holyoke,  the 
center  of  this  industry  in  Massachusetts,  with  those  of  the  State  at 
large,  showed  "  that  the  Holyoke  rates  were  under  rather  than  over 
the  average."" 

Chapter  IV. 

OCCUPATIONS  INVOLVING  EXPOSURE  TO  POISONOUS  DUST. 

LEAD  DUST. 

All  occupations  in  which  lead  is  employed  and  in  which  particles 
of  lead  may  be  inhaled,  swallowed,  or  absorbed  by  the  skin  must  be 
regarded  as  dangerous  to  health.  Lead  poisoning  in  its  various 
forms,  such  as  the  lead  habit,  characterized  by  loss  of  weight,  anaemia, 
sallow  skin,  a  blue  line  along  the  gums,  offensive  breath,  a  sweetish 
taste  and  diminished  salivary  secretion,  lead  colic,  lead  paralysis, 
wrist  drop,  painful  affections  of  the  lower  extremities,  and  other 
grave  nervous  diseases,  is  frequently  seen  in  artisans.  It  attacks  per- 
sons employed  in  the  roasting  of  lead  ores,  in  the  manufacture  of 
white  and  red  lead,  acetate  and  chromate  of  lead,  china  and  pottery, 
artificial  flowers;  also  painters,  plumbers,  varnishers,  type  founders, 
typesetters,  file  cutters,  glass  and  gem  cutters,  electricians  (especially 
those  employed  in  charging  storage  batteries),  persons  engaged  in 
enameling,  dyeing,  printing,  working  in  rubber  goods,  weighted  silk, 
and  glazing  of  paper,  and  many  other  occupations  involving  the  em- 
ployment of  lead.  • 

Doctor  Teleki,  of  Vienna,  in  1906  reported  several  cases  of  lead 
poisoning  in  females  and  young  girls,  contracted  in  fringe  making, 
the  silk  having  been  weighted  by  a  solution  of  sugar  of  lead. 

Of  999  employees  in  Prussian  lead  smelters  during  the  year  1905, 
177  suffered  from  lead  colic  or  lead  palsy,  involving  3,056  days'  loss 
of  work ;  and  of  4,789  engaged  in  zinc  smelters,  50  of  the  employees, 
with  2,217  days'  loss  of  work,  were  thus  affected. 

In  Europe  a  most  marked  reduction  in  the  morbidity  and  mort,ality 
has  taken  place  during  the  past  ten  years,  coincident  with  the  enforce- 
ment of  preventive  measures.  The  number  of  cases  of  lead  poisoning 
in  England,  where  report  is  compulsory,  has  been  reduced  from  1,278 
cases  in  1898  to  592  cases  in  1905.  While  most  of  the  cases  occurred 
in  sugar  of  lead  works  and  potterias,  a  considerable  number  were  also 
reported  in  the  other  occupations  already  referred  to.  The  percentage 
of  severe  cases  in  men  was  23.9,  as  compared  with  13.9  in  females — 
perhaps  because  the  latter  have  cleaner  habits  and  possibly  also  stop 
work  more  j)romptly  upon  the  appearance  of  the  first  symptoms. 

In  Paris  it  is  estimated  that  over  30,000  persons  are  engaged  in 
occupations  involving  exposure  to  lead,  and  of  the  14,000  painters  and 
varnishers  employed  there  an  average  of  250  are  treated  annually  in 
the  hospitals  for  lead  poisoning. 

« Report  of  the  State  Board  of  Health  of  Massachusetts  upon  the  sanitary 
condition  of  factories,  workshops,  etc.,  1907. 


REPORTS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  49 

File  cutters  are  not  only  subjected  to  an  irritant  dust,  but  also  to 
lead  poisoning,  because  the  file  in  cutting  is  being  held  upon  a  leaden 
bed  "  and  particles  of  lead  are  inhaled  with  the  dust  and  may  also  be 
absorbed  by  the  fingers  in  handling  the  stiddy."  The  mortality  figure 
for  plumbism  in  1890-1892  was  no  less  than  75.° 

The  greatest  danger  in  lead  works  is  from  inhalation  of  the  lead 
dust  and  fumes ;  hence  a  special  spray  apparatus  and  exhausters  have 
been  designed,  and  employees  have  been  taught  to  protect  their  hands 
with  gloves  and  the  mouth  and  nose  with  respirators. 

In  the  pottery  industry,  where  the  danger  arises  from  the  glazes, 
the  flux  being  made  of  litharge,  clay,  and  flint,  it  has  been  found  that 
the  danger  can  be  very  much  reduced  by  using  only  8  per  cent  of  car- 
bonate of  lead  in  the  form  of  a  "  double- fritted  silicate,"  instead  of 
the  older  method,  in  which  from  13  to  24  per  cent  of  lead  carbonate 
was  employed. 

Smoking  should  be  forbidden  during  the  working  hours,  and  the 
work  should  be  done  in  a  special  suit,  frequently  washed.  The  hands, 
face,  and  nostrils  should  be  thoroughly  washed  with  soap  and  water 
upon  cessation  of  work,  and  the  mouth  and  throat  rinsed  with  a 
watery  solution  of  tartrate  of  ammonia  before  eating  and  drinking. 
The  same  rules  are  applicable  to  painters,  who  would  likewise  find  it 
of  benefit  to  soften  old  paints  with  an  alkali  (weak  lye)  before  scrap- 
ing and  to  keep  the  handles  of  tools  clean  from  deposits. 

THE   LEAD   INDUSTRY   IN    MASSACHUSETTS. 

The  report  of  the  Massachusetts  board  of  health  *  gives  a  very 
complete  account  of  the  conditions  which  obtain  in  the  manufacture 
of  lead  compounds  in  the  several  factories  visited.  "  The  men  who 
attend  the  grinding  machines  are  of  a  very  different  class  from  those 
who  empty  the  stacks,  and  since  they  are  not  exposed  to  lead  dust  they 
do  not  suffer  from  lead  poisoning  and  are  comparatively  healthy. 
Those  who  empty  the  stacks  do  not  remain  long  at  work.  It  is  said 
that  this  is  due  in  part  to  the  disagreeable  nature  of  the  work,  in  part 
to  the  fact  that  they  are  largely  roving  characters,  who  do  not  care  to 
work  more  than  a  few  days  occasionally,  and  in  part  to  the  fact  that 
they  acquire  lead  poisoning  and  are  obliged  to  quit.  Even  those  of 
good  intentions  rarely^  work  more  than  a  month." 

One  establishment  is  referred  to  where  white  lead  is  made  by  the 
"  wet  process,"  with  no  evolution  of  dust,  and  there  is  no  history  of 
lead  poisoning.  In  a  "  red-lead  "  factory,  also,  the  general  process  is 
commended,  especially  the  absence  of  appreciable  amounts  of  dust, 
and  the  intelligence  of  the  workmen,  who  are  mindful  of  the  dangers 
and  who,  with  an  experience  of  six  to  twenty-five  years,  appear  well 
and  strong.  In  one  of  the  lead-oxide  works  more  or  less  dust  escapes 
into  the  air  during  the  transfer  to  the  mill  and  packing  it  into  barrels. 
The  men  wear  respirators,  and  each  man  washes  carefully  and 
changes  all  his  clothes  before  leaving  the  establishment.  In  another 
establishment  "  all  of  the  40  employees  appeared  to  be  in  good  health, 
and  the  conditions  everywhere  were  found  to  be  commendable." 

In  the  lead-pipe  and  plumbers'  supplies  factories  the  lead  fumes 
are  carried  away  by  hoods  and  exhaust  pipes,  and  in  no  instance  was 
it  possible  to  trace  a  case  of  lead  poisoning  to  faulty  methods.  All 
of  the  employees  observed  the  necessary  precautions  and  appeared 

«  Dangerous  Trades,  Oliver,  1902,  p.  138, 
»  Page  99. 
S.  Doc.  644,  60-2 5 


50  REPOBTS  OF  THE  PRESIDENT'S  HOMES  COMMISSION. 

to  be  in  good  health.  In  the  manufacture  of  solder  the  same  precau- 
tions are  employed,  and  although  in  the  establishment  described,  rats, 
cats,  and  dogs  appear  to  succumb  to  lead  poisoning,  only  one  case  of 
lead  poisoning  occurred  among  the  employees  in  thirty-five  years. 

In  the  pottery  industry  it  is  said  that  lead  poisoning  is  almost 
unknown  in  the  six  establishments  visited;  only  two  cases  occurred 
a  few  years  ago  in  girls  who  applied  the  glaze.  A  possible  explana- 
tion foi  this  gratifying  contrast  to  conditions  observed  in  French  and 
English  potteries  may  be  found  in  the  fact  "  that  the  persons  engaged 
in  this  industry  appear  to  be  of  good  intelligence  and  understand 
thoroughly  the  importance  of  care  and  strict  personal  cleanliness,  and 
that  the  employers  provide  ample  means  for  its  maintenance.  " 

Wire  and  wire-cloth  making  as  carried  on  in  some  of  the  plants 
visited  in  Massachusetts  appear  to  be  attended,  in  the  opinion  of 
Doctor  Hanson,®  by  "  avoidable  dangerous  conditions."  "After  the 
wire  is  hardened  by  being  run  into  crude  oil,  it  is  passed  through  ket- 
tles of  molten  lead  inside  the  tempering  furnaces  and  is  then  finished 
and  wound  for  shipment.  From  the  tempering  furnaces  dense  blue 
fumes  arise  and  envelop  the  men  whose  work  it  is  to  feed  and  tend 
them.  Occasional  cases  of  lead  poisoning  occur  in  this  department. 
In  one  establishment  one  of  the  employees  of  five  years'  experience 
shows  the  characteristic  blue  line  of  lead  poisoning  on  the  gums,  and 
another  of  fourteen  years'  experience,  in  the  same  room,  has  a  history 
of  '  wrist-drop  '  and  other  evidence  of  chronic  poisoning.  Efficient 
mechanical  ventilation  is  most  necessary  in  this  work,  but  it  is  not 
always  provided."  * 

Doctor  Hanson,  evidently  referring  to  the  same  factory,  writes : 

All  of  the  employees  in  this  room  worked  eleven  hours  a  day  and  had  irregu- 
lar hours  for  eating.  There  were  no  rules  concerning  the  duties  of  the  em- 
ployers or  those  of  the  persons  employed  in  order  to  avoid  this  serious  danger. 
On  the  contrary,  the  hoods  and  blowers  and  top  ventilators  for  the  lead  and 
other  fumes  were  found  to  be  distinctly  inefficient,  and  over  oije  large  furnace 
there  was  no  protection  of  any  sort,  the  appliances  having  been  broken  years 
before  and  none  renewed,  so  that  all  the  fumes  mingled  at  once  with  the  air  of 
the  room. 

In  making  shingle  stains,  pigments  like  chromate  of  lead,  zinc 
oxide,  iron  oxide,  and  Prussian  blue  are  used,  and  in  the  two  estab- 
lishments visited  the  men  appeared  to  be  careless  in  the  matter  of 
handling  the  pigments.*'  In  the  manufacture  of  paints,  colors,  and 
varnishes  much  of  the  work  is  done  outdoors  by  men  who  have 
worked  from  six  to  twenty  years;  the  man  who  makes  the  lead  colors 
has  worked  seventeen  years  without  sickness.**  The  last  case  of 
poisoning  at  this  establishment  occurred  sixteen  years  ago,  ^\\\vu  a 
number  of  inexperienced  men  were  poisoned  with  Paris  green.  In  a 
color  and  mordant  factory  where  aniline  colors,  logwood,  starch, 
sodium  dichromate,  etc.,  are  used,  "  about  one  in  five  of  the  employees 
is  noticeably  pale  and  sallow,  and  inflamed  eyes  were  not  uncommon." 
The  latter  condition  is  ascribed  to  the  sodium  dichromate.  In  the 
manufacture  of  "  whiting  "  about  half  of  the  58  men  employed  in 
three  establishments  visited  "  looked  to  be  in  poor  condition." 

<»"The  effect  of  industry  on  health,"  Boston  Med.  Journal,  No.  14,  April  4, 
1907,  Wm.  C.  Hanson. 

^  Report  of  the  State  Board  of  Health  of  Massachusetts,  1907,  p.  91. 
c  Page  106. 
*Page  107. 


BEPORTS    OF    THE   PRESIDENT  S   HOMES   COMMISSION. 


51 


PRINTERS,  TYPE  FOUNDERS,  AND  TYPESETTERS. 

The  mortality  of  printers  in  England  is  high,  being  1,096  per 
10,000,  as  against  953  for  all  occupied  males  and  602  for  agricultural- 
ists.^ According  to  Schuler,  of  1,000  Swiss  type  setters  and  founders, 
304.7  are  annually  taken  sick,  and  of  printers  250.  Diseases  of  the 
digestive  organs  predominate  (78  per  1,000).  Diseases  of  the  respira- 
tory passages  come  next  (75  per  1,000).  Sommerfeld  states  that 
among  38  occupations  tabulated  by  him  the  printers  occupy  the  fifth 
rank  in  the  number  of  deaths  from  tuberculosis.  Albrecht  reports 
that  the  statistics  of  the  Berlin  Sick  Benefit  Insurance  Company  cov- 
ering a  period  of  thirty-three  years  show  that  48.13  per  cent  of  the 
deaths  among  printers  are  caused  by  consumption.^ 

This  may  be  due  in  part  to  the  fact  that  many  weaklings  engage  in 
this  occupation,  but  the  work  itself  is  often  performed  in  most  unfa- 
vorable environments  and  in  an  impure  and  dusjty  atmosphere,  which 
has  been  found  to  contain  traces  of  lead,  arsenic,  and  antimony.  Spe- 
cial attention  should  be  paid  to  proper  ventilation,  and  particularly  to 
the  collection  and  removal  of  dust  from  the  type  cases.  One  gram  of 
this  dust  has  been  found  to  contain  57.7  mg.  of  lead,  186.8  mg.  of 
antimony,  and  traces  of  arsenic.*'  Strasesr  has  suggested  a  type  case 
with  perforated  tin  bottom  which  is  placed  within  another  case,  so  as 
to  facilitate  the  collection  and  proper  disposition  of  this  injurious 
form  of  dust. 

A  recent  study  of  the  "  Health  of  Printers  "  by  George  A.  Stevens, 
in  the  Twenty-fourth  Annual  Report  of  the  Bureau  of  Labor  Statis- 
tics of  New  York,  based  on  the  records  of  the  International  Typo- 
graphical Union  and  the  London  (England)  Society  of  Compositors, 
shows  clearly  the  very  high  death  rate  from  tuberculosis  among 
printers. 

The  following  table  gives  for  the  years  1901  to  1905  the  annual  death 
rates  per  1,000  from  the  leading  causes  and  from  all  causes  among 
compositors  in  certain  localities: 


Annual  death  rate  per  1,000  from  principal  causes  and  all  causes  among  com- 
positors in  certain  localities,  for  the  five  years,  1901  to  1905. 

[From  Twenty-fourth  Annual  Report  of  the  Bureau  of  Labor  Statistics,  1906.] 


Death  rate  per  1,000. 


o2« 

'41 

p  S  u 

^  s  ft 


«a 


2. 


X   It 


.2  ^ 


bo 


s3.S 


a 

03  <n 


New  York  City 

other  New  York  State  . 
Total  New  York  State. . 

Chicago,  111 

Philadelphia.  Pa 

All  other  United  States 
Total  United  States  . . . . 
London,  England 


3.82 
2.54 
3.48 
2.42 
3.65 
3.38 
3.34 


2.42 

.97 

2.03 

1.57 

.70 

1.07 

1.30 

.67 


1.91 
1.49 
1.89 
1.04 
2.20 
L33 
1.44 
L16 


L63 
.70 

1.38 
.98 
.70 

1.02 

1.08 
.51 


1.37 
1.67 
1.45 
1.44 
1.39 
1.37 
1.39 
1.97 


0.99 
.97 
.98 
.45 
.52 
.74 
.76 
.61 


0.89 
.61 

.82 
.72 


.60 
.64 
.19 


16.32 
11.14 
14.94 
10.12 
12.35 
12.20 
12.63 
12.19 


°  Dangerous  Trades,  Oliver,  p.  151. 

^Roth  Kompendium  der  Gewerbe-Krankheiten,  Berlin,  1904,  p.  56. 

«  Roszahegyi,  Archiv,  fuer  Hygiene,  III,  p.  522. 


5^ 


REPORTS  0^  THE  PRESIDENT'S  HOMES  COMMISSION. 


A  second  table  gives  for  the  same  period  the  per  cent  of  deaths  due 
to  tuberculosis  in  the  selected  localities  for  compositors  and  for^all 
persons  20  years  of  age  and  over.  It  will  be  seen  that  in  all  the  local- 
ities the  percentage  of  deaths  due  to  tuberculosis  is  very  much  higher 
for  compositors  than  for  all  persons  20  years  of  age  and  over  in  the 
same  communit3^  For  New  York  State  outside  of  New  York  City 
and  for  London,  England,  the  percentage  for  compositors  is  more 
than  double  that  for  the  population  20  years  of  age  and  over  as  a 
whole. 

Per  cent  of  deaths  from  tuberculosis  of  the  hmgs  and  other  respiratory  organs 
of  persons  20  years  of  age  and  over  and  of  compositors  in  c&rtain  localities: 
1901  to  1905. 

[From  the  Twenty-fourth  Annual  Report  of  the  Bureau  of  Labor  Statistics  of  New  York, 

p.  cxxv.] 


Locality. 


ALL  PERSONS  20  YEARS  OF  AGR  AND  OVER. 


New  York  City 

other  New  York  State 
Total  New  York  State 

Chicago,  ni 

Philadelphia,  Pa 


COMPOSITORS. 


New  York  City 

Other  New  York  State.. 
Total  New  York  State. . . 

Chicago,  111 

Philadelphia,  Pa 

All  other  United  States . 
Total  United  States 


1901. 


17.7 
11.4 
14.5 
14.9 
16.3 


London,  England 14. 9 


36.5 
29.2 
34.9 
26.9 
43.8 
31.1 
32.  3 
London,  England |    32. 0 


Per  cent  of  deaths  in^ 


1902. 


17.7 
10.9 
14.2 
14.6 
15.5 
13.9 


17.0 
32.3 
20.8 
28.0 
50.0 
2ii.9 
27.8 
26.2 


1903. 


17.6 
10.6 
14.0 
14.5 
15.8 
15.3 


18.2 
10.6 
17.1 
28.0 
7.1 
24.0 
22.2 
36.4 


1904. 


16.5 
10.6 
13.6 
16.0 
16.8 
15.0 


26.6 
21.4 
25.  5 
7.7 
13.3 
26.0 
24.4 
28.2 


1905. 


17.4 
10.6 
13.9 
17.0 
16.9 
13.6 


21.1 
16.0 
20.1 
33.3 
35  7 
29.2 
27.2 
29.1 


Five 
years. 


17.4 
10.8 
14.0 
15.4 
16.1 
14.5 


23.4 
22.8 
23.3 
23.9 
29.6 
27.7 
26.4 
30.2 


Mr.  Stevens,  in  commenting  on  the  high  death  rate  from  tubercu- 
losis among  compositors,  says: 

Scarcely  any  other  occupation  furnishes  so  large  a  quota  of  victims  from 
consumption.  The  domestic  life  of  printers  is  parallel  to  that  of  other  artisans 
in  equal  financial  circumstances.  As  wages  go  in  these  days,  they  are  fairly 
compensated  for  their  labor,  thus  enabling  them  to  have  homes  as  healthful 
as  may  be  procured  by  the  best-paid  workmen  in  any  community.  Neither  can 
it  be  said  that  compositors  are  ill  nourished  and  therefore  rendered  more  sus- 
ceptible to  the  insidious  action  of  tubercle  bacilli.  The  determining  cause  of 
their  susceptibility  to  the  harmful  process  of  the  "  great  white  plague "  lies 
in  a  different  direction — to  the  neglect  of  sanitary  precautions  in  far  too  many 
composing  rooms. 

With  proper  attention  to  sanitary  conditions  in  the  composing 
rooms  the  death  rate  from  consumption  could  undoubtedly  be  very 
materially  reduced.  The  excellent  results  that  have  come  from  im- 
proved sanitation  in  workrooms  appears  from  the  mortality  statistics 
for  1905  of  the  National  Organization  of  Printers  in  Germany. 
''  The  average  membership  of  the  union  in  that  year  was  44,236,  of 
whom  283,  or  6.40  per  1,000,  died  from  all  causes,  while  134  of  the 
total   were  affected  with  diseases  of  the  respiratory  system,  from 


EEPORTS   OF    THE  PRESIDENT'S   HOMES   COMMISSION.  53 

which  the  death  rate  was  3.03,*»  tuberculosis  not  being  separated  in 
the  tabular  presentation."  * 

The  regulations  of  the  federal  council'  of  the  German  Empire 
which  control  sanitary  conditions  in  German  printing  houses  (put 
into  effect  July  31,  1897)  will  indicate  the  means  by  which  such 
low  death  rates  have  been  brought  about.  The  regulations  are  given 
in  full: 

I.  In  rooms  in  which  persons  are  employed  in  setting  up  type  or  manufacture 
of  type  or  stereotype  plates  the  following  provisions  apply : 

1.  The  floor  of  workrooms  must  not  be  sunk  deeper  than  half  a  meter  (1.64 
feet)  below  the  ground.  Exceptions  may  only  be  granted  by  the  higher  admin- 
istrative authority  where  hygienic  conditions  are  secured  by  a  dry  area  and 
ample  means  of  lighting  and  ventilating  the  rooms. 

Attics  shall  only  be  used  as  workrooms  if  the  roof  is  underdone  with  lath 
and  plaster. 

2.  In  workrooms  in  which  the  manufacture  of  type  or  stereotype  plates  is 
carried  on  the  number  of  persons  must  not  exceed  such  as  would  allow  at  least 
15  cubic  meters  of  air  space  (529.74  cubic  feet)  to  each.  In  the  rooms  in  which 
persons  are  employed  only  in  other  processes  there  must  be*at  least  12  cubic 
meters  of  air  space  (423.79  cubic  feet)  to  each  person. 

In  cases  of  exceptional  temporary  pressure  the  higher  administrative  au- 
thority may,  on  the  application  of  the  employer,  permit  a  larger  number  in  the 
workrooms  for  at  the  most  thirty  days  in  the  year,  but  not, more  than  will 
allow  10  cubic  meters  of  air  space  (353.16  cubic  feet)  for  each  person. 

3.  The  rooms  must  be  at  least  2.60  meters  (8.528  feet)  in  height  where  a 
minimum  15  cubic  meters  are  allowed  for  each  person,  in  other  cases  at  least 
3  meters  (9.84  feet)  in  height. 

The  rooms  must  be  provided  with  windows  which  are  sufficient  in  number 
and  size  to  let  in  ample  light  for  every  part  of  the  work.  The  windows  must 
be  so  constructed  that  they  will  open  and  admit  of  complete  renewal  of  air  in 
workrooms. 

Workrooms  with  sloping  roofs  must  have  an  average  height  equal  to  the 
measurements  given  in  the  first  paragraph  of  this  section. 

4.  The  rooms  must  be  laid  with  a  close-fitting  impervious  floor,  which  can 
be  cleared  of  dust  by  moist  methods.  Wooden  floors  must  be  smoothly  planed, 
and  boards  fitted  to  prevent  penetration  of  moisture. 

All  walls  and  ceilings  must,  if  they  are  not  of  a  smooth,  washable  surface 
or  painted  in  oil,  be  lime  washed  at  least  once  a  year.  If  the  walls  and  ceilings 
are  of  a  smooth  washable  surface  or  painted  in  oil,  they  must  be  washed  at  least 
once  a  year,  and  the  oil  paint  must,  if  varnished,  be  removed  once  in  ten  years, 
and  if  not  varnished,  once  in  five  years. 

The  compositors'  shelves  and  stands  for  type  boxes  must  be  either  closely 
ranged  round  the  room  on  the  floor  so  that  no  dust  can  collect  underneath,  or  be 
fitted  with  long  legs  so  that  the  floor  can  be  easily  cleared  of  dust  underneath. 

5.  The  workrooms  must  be  cleaned  and  thoroughly  aired  at  least  once  a  day, 
and  during  the  working  hours  means  must  be  taken  to  secure  constant 
ventilation. 

6.  The  melting  vessel  for  type  or  stereotype  metal  must  be  covered  with 
a  hood  provided  with  exhaust  ventilation  or  chimney  with  sufficient  draft  to 
draw  the  fumes  to  the  outer  air. 

Type  founding  and  melting  may  only  be  carried  on  in  rooms  separate  from 
other  processes. 

7.  The  rooms  and  fittings,  particularly  the  walls,  cornices,  and  stands  for 
type,  must  be  thoroughly  cleaned  twice  a  year  at  least.  The  floors  must  be 
washed  or  rubbed  over  with  a  damp  cloth  so  as  to  remove  dust  once  a  day  at 
least. 

8.  The  type  boxes  must  be  cleansed  before  they  are  put  in  use,  and  again  as 
often  as  necessary,  but  not  less  than  twice  at  least  in  the  year. 

« The  corresponding  death  rate  among  compositors  in  New  York  City  was 
7.17;  other  New  York  State,  4.04;  total  New  York  State,  6.34;  Chicago,  5.04; 
Philadel])hia,  4.70;  total  United  States,  5.02;  and  London,  England,  5.50. 

*  Twenty-fourth  Annual  Report  of  the  Bureau  of  Labor  Statistics  of  New 
York;  1906,  p.  cxxxvii. 


54  REPORTS  OF   THE  PRESIDENT  S  HOMES  COMMISSION. 

ITne  boxes  shall  only  be  dusted  out  with  a  bellows  in  the  open  air,  and  this 
work  shall  not  be  done  by  young  persons. 

9.  In  every  workroom  spittoons  filled  with  water,  and  one  at  least  for  every 
five  persons,  must  be  provided.    Workers  are  forbidden  to  spit  upon  the  floor. 

10.  Sufficient  washing  appliances  with  soap,  and  at  least  one  towel  a  week 
for  each  worker,  must  be  provided  in  or  as  near  as  possible  to  the  workrooms 
for  compositors,  cutters,  and  polishers. 

One  wash  hand  basin  must  be  provided  for  every  five  workers,  with  an  ample 
supply  of  water.    The  wash  basin  after  its  use  by  each  person  must  be  emptied. 

The  employer  must  make  strict  provision  for  use  of  the  washing  appli- 
ances by  workers  before  every  meal,  and  before  leaving  their  work. 

11.  Clothes  put  off  during  working  hours  must  either  be  kept  outside  the 
workroom  or  hung  up  in  wardrobes  with  closely  fitting  doors  or  curtains,  which 
are  so  shut  or  drawn  as  to  prevent  penetration  of  dust. 

12.  Artificial  means  of  lighting  which  tend  to  raise  the  temperature  of  the 
rooms  must  be  so  arranged  or  provided  with  counteracting  measures  that  the 
heat  of  the  workrooms  shall  not  be  unduly  raised. 

13.  The  employer  must  draw  up  rules  binding  on  the  workers,  which  will 
insure  the  full  observance  of  the  provisions  in  sections  8,  9,  10,  and  11.  In  an 
establishment  where  as  a  rule  twenty  people  are  employed  these  rules  shall  be 
inserted  in  the  general  factory  regulations,  in  accordance  with  section  134a  of 
the  industrial  code. 

II.  In  every  workroom  a  notice  must  be  posted,  signed  by  the  local  police 
authority,  attesting  to  the  correctness  of  the  statements  concerning  (a)  the 
length,  height,  and  breadth  of  rooms,  (&)  the  air  space  in  cubic  measure,  (c) 
and  the  number  of  workers  permitted  in  each  room. 

A  copy  of  rules  1  to  13  must  be  affixed  where  it  can  be  easily  read  by  all 
persons  affected. 

III.  Provides  for  the  method  of  permitting  the  exceptions  named  above  in 
sections  2  and  3,  and  makes  it  a  condition  of  reduction  in  cubic  air  space  for 
each  person  employed  as  typefounder  or  compositor  that  there  shall  be  adequate 
mechanical  ventilation  for  regulating  temperature  and  carrying  off  products 
of  combustion  from  workrooms. 

For  an  interesting  report  on  plumbism  and  the  health  of  employees 
in  the  Government  Printing  Office,  Washington,  D.  C.,  by  Wm.  J. 
Manning,  M.  D.,  see  Appendix  A. 

ARSENICAL  DUST. 

Arsenic  is  used  in  the  manufacture  of  green  pigments  such  as  arse- 
nite  of  copper  (Scheele's  green)  and  aceto-arsenite  of  copper 
(Schweinfurt  or  Paris  green).  These  pigments  are  used  in  connec- 
tion with  wall  paper,  box  and  card  factories,  the  cretonne  industry, 
and  artificial  flowers,  possibly  also  in  other  occupations.  White 
arsenic  is  also  used  in  the  manufacture  of  shot,  preservation  of  furs, 
and  in  taxidermy,  and  for  many  other  purposes. 

In  the  manufacture  of  arsenate  of  lead  in  Massachusetts  no  objec- 
tionable features  were  observed."  Keference  has  already  been  made 
to  cases  of  poisoning  with  Paris  green. 

One  of  the  factory  inspectors  of  East  London  reported  last  year 
a  number  of  cases  of  arsenical  poisoning  in  persons  engaged  in  the 
manufacture  of  a  powder  used  in  a  "  dip  "  for  scabby  sheep.  The 
powder  contained  arsenic  in  large  amounts,  and  was  packed  in  a  dry 
state  in  paper  boxes.  Arsenical  dust  may  be  inhale  d,  but  more  fre- 
quently absorption  takes  place  through  the  skin,  and  causes  a  train 
of  symptoms,  characterized  by  derangements  of  the  stomach,  sore 
mouth,  dry  tongue,  thirst,  and  a  burning  sensation  in  the  throat.  In 
the  majority  of  instances  the  symptoms  become  chronic,  lasting  for 

0  Report  of  the  State  Board  of  Health  of  Massachusetts,  1907,  p.  104. 


HEPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  55 

months  and  years,  and  terminating  in  a  general  breakdown  of  the 
system,  preceded  by  skin  eruptions,  obstinate  ulcers,  and  inflamma- 
tion of  the  peripheral  nerves. 

In  the  prevention  of  injurious  effects  special  attention  must  be  paid 
to  wet  processes;  so,  for  example,  the  dusting  of  green  pigments  in 
the  manufacture  of  artificial  leaves  and  flowers  from  a  dredging  box 
is  wholly  unjustifiable.  As  a  matter  of  fact,  the  use  of  arsenical  pig- 
ments should  be  dispensed  with  by  the  substitution  of  coal-tar  colors. 
The  hands  should  always  be  protected  with  rubber  gloves,  the  air 
passages  with  respirators,  and  strict  cleanliness  of  the  skin  and  cloth- 
ing should  be  observed. 

Chapter  V. 

OCCUPATIONS   INVOLVING   EXPOSURE   TO    IRRITATING   OR   POISON- 
OUS GASES  OR  VAPORS. 

A  large  number  of  occupations  involve  the  inhalation  of  irritating 
and  even  poisonous  gases  and  fumes.  The  danger  may  be  very  much 
reduced  by  proper  factory  sanitation,  such  as  (1)  condensation;  (2) 
absorption  by  water  or  chemicals;  (3)  destructive  distillation  by  heat 
in  a  closed  vessel;  (4)  combustion  of  gases  that  can  be  burned;  (5) 
forced  ventilation  and  the  discharge  of  gases  into  the  air  at  a  great 
height.  In  addition  to  these  precautions  much  attention  must  be 
paid  on  the  part  of  the  operatives  themselves  to  personal  hygiene  and 
the  use  of  respirators.  Many  of  the  employees  in  so-called  danger- 
ous trades  do  not  always  avail  themselves  of  the  safeguards  offered 
and  are  oposed  to  the  use  of  respirators.  We  shall  first  briefly  enu- 
merate the  less  injurious,  but  nevertheless  irritating,  gases  and  fumes, 
like  sulphur  dioxide,  hydrocholic  acid,  and  nitrous  fumes,  ammonia 
and  chlorine,  which  in  small  amounts  cause  more  or  less  irritation  of 
the  air  passages  and  a  tickling  cough,  while  in  a  more  concentrated 
form  they  are  productive  of  acute  and  chronic  catarrhs  and  constitu- 
tional symptoms. 

SULPHUR  DIOXIDE. 

This  gas  is  believed  to  be  a  blood  poison,  on  account  of  its  affinity 
for  oxygen.  It  is  evolved  in  smelting  works,  match  factories,  and  in 
the  manufacture  of  sulphuric  acid.  It  is  is  also  used  as  a  bleaching 
agent  for  cotton  goods  and  straw  hats  and  in  the  preparation  of  hops 
and  dried  fruit.  The  employees,  if  not  primarily  in  good  health,  are 
said  to  suffer  from  respiratory  and  digestive  disorders,  heartburn, 
and  pain  in  the  stomach,  and  are  frequently  sallow  and  anaemic.  A 
gradual  tolerance  may  be  established,  and  the  danger  is  very  slight 
if  free  ventilation  is  provided.  When  evolved  in  the  open  air,  and 
hence  largely  diluted,  it  does  not  produce  any  injurious  effects,  except 
in  very  susceptible  persons;  indeed,  the  people  around  Vesuvius  told 
Doctor  De  Chaumont  that  the  sulphur  fumes  are  good  for  their 
health. 

The  Massachusetts  board  of  health  found  that,  in  the  straw -hat 
factories  visited  in  Massachusetts,  "  the  employees  are  exposed  to  the 
sulphur  fumes  only  when  the  doors  are  opened  for  the  removal  of  the 
stock;  but  they  do  not  enter  until  the  fumes  have  escaped  or  have 
been  driven  out."    The  men  do  not  wear  respirators  in  this  or  the 


56  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

other  process  of  bleaching,  which  is  done  by  immersion  of  the  stock 
in  a  chemical  water  bath.  The  men  who  were  interviewed  state  that 
"  neither  process  causes  anything  more  than  a  temporary  irritation 
of  the  throat,  and  that  many  of  them  have  worked  in  this  department 
for  many  years."* 

HYDROCHLORIC  ACID. 

Hydrochloric-acid  vapors  are  evolved  from  alkali  works  and  in 
the  pickling  process  of  galvanizing  works  or  otherwise,  and,  apart 
from  being  destructive  to  vegetation  around  the  immediate  vicinity, 
are  also  very  irritating,  and  even  in  small  volumes  may  produce  in- 
flammation of  the  eyes  and  of  the  respiratory  passages.  In  a  more 
concentrated  form  they  have  produced  caustic  effects  on  the  tips  and 
edges  of  the  tongue,  ulcerations  of  the  nasal  wall  and  throat,  bron- 
chial catarrh,  pneumonia,  difficult  breathing,  and  stupor.  Lehmann  * 
considers  the  extreme  limit  to  which  these  vapors  may  be  contained 
in  the  air  0.1  of  volume  per  1,000,  and  relates  a  case  where  even  0.5 
per  1,000  produced  unpleasant  symptoms  in  a  robust  man.  Petten- 
koffer,*'  on  the  other  hand,  states  that  as  much  as  1  part  per  1,000 
can  be  borne  by  those  accustomed  to  it.  The  workmen  in  galvanizing 
works  are  also  subjected  to  fumes  arising  from  the  sal  ammoniac 
thrown  upon  the  molten  zinc.  These  fumes  are  to  some  more  in- 
supportable than  the  acid  fumes.  Persons  with  bronchial  troubles 
are  often  obliged  to  discontinue  the  work.  In  an  investigation  of 
three  galvanizing  establishments  in  Boston,  the  Massachusetts  board 
of  health  found  that  in  two  the  ventilation  was  efficient  and  the 
fumes  were  rapidly  carried  off.  "  The  workmen  in  all  three,  about 
60  in  all,  appeared  to  be  in  good  health,  and  asserted  that  beyond 
sneezing  and  coughing  at  times  they  suffered  no  inconvenience  or 
discomfort." 

SULPHURIC  AND  NITRIC  ACID. 

The  fumes  of  sulphuric  and  nitric  acids  probably  produce  similar 
effects.  Eulenberg^  believes,  however,  that  the  fumes  of  sulphuric 
acid  produce  no  special  bad  effects,  because  they  sink  very  readily 
and  have  a  great  affinity  for  the  water  in  the  air,  so  that  they  reach 
the  system  in  a  highly  diluted  form.  He  also  points  out  that  the 
nitrous  fumes  generated  by  contact  of  nitric  acid  with  metals  are 
more  injurious,  in  that  they  produce  a  special  predisposition  to  bron- 
chitis, while  pneumonia  and  diseases  of  the  eye  have  also  been  at- 
tributed to  these  gases. 

The  workmen  should  be  instructed  to  avoid  the  fumes  as  much  as 
possible  and  to  anoint  the  lips  and  nose  within  and  without  several 
times  a  day.  Protection  should  be  afforded  by  ample  ventilation,  and 
all  processes  involving  the  evolution  of  irritating  or  poisonous  fumes 
should  be  carried  on  in  the  open  air  or  in  open  sheds. 

o  Report  of  the  State  Board  of  Health  of  Massachusetts  upon  the  sanitary 
condition  of  factories,  worlishops,  etc.,  Boston,  1907,  p.  114. 
*  Lehmann:  Archiv.     fuer  Hygiene,  vol.  i. 
•Cited  by  Harrington. 
'Eulenberg,  Gewerbehygiene,  p.  143. 


BEPOBTS   OF   THE  PBESIDENT^S  HOMES  COMMISSION.  57 

According  to  the  Massachusetts  board  of  health «  the  corrosive 
acids  are  made  in  such  a  way  that  practically  no  fumes  whatever 
escape,  the  work  being  inclosed  from  beginning  to  end.  In  one  of 
the  largest  chemical  factories  in  Massachusetts,  where  300  men  are 
employed,  it  is  said  that  the  workmen  are  exposed  very  little  to 
poisonous  or  irritating  fumes  and  dust  or  contact  with  poisonous  or 
irritating  substances.  At  certain  points  in  the  building  acid  fumes 
in  considerable  strength  are  constantly  present,  but  at  these  points 
there  is  good  overhead  ventilation,  and  the  workmen  are  rarely 
obliged  to  approach  very  near. 

Among  the  products  of  the  above-mentioned  factories  may  be  men- 
tioned hydrochloric,  sulphuric  acid,  nitric  acid,  acetic  acid,  ammonia, 
sodium  sulphite,  sodium  sulphate,  alum,  potassium  cyanide,  ferrous 
sulphate,  and  other  iron  and  sodium  salts;  also  various  salts  of  tin, 
arsenic,  antimony,  zinc,  copper,  etc. 

AMMONIA. 

Ammonia  rarely  causes  any  serious  disturbance,  except  a  tempo- 
rary iritation  of  the  respiratory  tract,  unless  present  in  very  large 
volumes.  The  amount  which  may  be  present,  according  to  Lehmann, 
should  not  exceed  0.5  per  1,000.  A  large  volume  has  been  known  to 
cause  inflammation  of  the  eyes  and  bronchial  catarrh,  while  still 
greater  concentrations,  which  fortunately  are  rare,  may  produce 
difficult  breathing  and  emphysema. 

CHLORINE   GAS. 

Chlorine  gas  is  generally  present  in  the  manufacture  of  chlorinated 
lime,  glazed  bricks,  and  in  bleaching  operations,  and  is  very  apt  to 
produce,  when  present  in  the  proportion  of  1  to  5  parts  in  100,000  of 
air,  a  cachectic  condition,  asthma,  bronchitis,  caries  of  the  teeth,  and 
acne  or  pimples  upon  the  face,  while  in  a  more  concentrated  form — ■ 
40  to  60  parts  in  100,000 — it  produces  a  violent  cough  and  extreme 
difficulty  in  breathing. 

Hirt  describes  these  attacks  as  follows: 

In  spite  of  the  aid  of  the  auxiliary  respiratory  muscles  the  entrance  of  the 
air  to  the  lungs  is  insufficient,  and  the  staring  eyes,  the  livid  lips,  and  the  cold, 
clammy  perspiration  plainly  show  the  mortal  agony  of  the  patient.  The  pulse 
is  small  and  temperature  decreased.  These  phenomena  disappear  upon  removal 
to  the  fresh  air,  and  a  few  hours  later  the  workman  is  found  enveloped  in 
chlorine  and  hydrochloric  acid  vapors  in  his  accustomed  place  in  the  factory. 
The  attacks  seem  to  be  but  rarely  fatal,  unless  the  volume  exceeds  60  parts 
per  100,000. 

BLEACHING   ESTABLISHMENTS. 

The  Massachusetts  board  of  health,  in  its  summary  of  five  bleach- 
eries,  with  about  1,200  employees,  speaks  approvingly  of  the  general 
arrangements  for  ventilation,  and  says: 

The  odors  of  bleaching  powders,  although  observable  in  each  of  the  rooms 
where  that  substance  is  employed,  were  in  no  case  so  strong  as  to  be  disa- 
greeable or  to  cause  discomfort.  In  one  of  the  establishments  the  persons 
exposed  to  the  lint  dust  which  escapes  during  unbaling  and  stitching  together 
of  the  cotton  cloth  all  looked  pale  and  sickly. 

«  Report  of  the  State  Board  of  Health  of  Massachusetts  upon  sanitary  condi- 
tions of  factories,  workshops,  etc.,  1907,  p.  103. 


68  EEPORTS   OF   THE  PRESIDENT'S   HOMES  COMMISSION. 

IODINE    AND    BROMINE    VAPORS. 

Iodine  and  bromine  vapors  may  produce  toxic  symptoms.  The 
fumes  of  iodine  are  liable  to  cause  catarrhal  conditions  of  the  nose, 
eyes,  and  air  passages,  and  frequent  headaches,  while  chronic  iodine 
poisoning  produces  a  cachectic  condition,  wasting  of  the  testicles,  and 
loss  of  sexual  power.  Persons  engaged  in  the  manufacture  of  bro- 
mine are  said  to  suffer  quite  frequently  with  a  form  of  bronchial 
asthma,  dizziness,  and  general  weakness,  while  concentrated  vapors 
have  been  known  to  produce  spasm  of  the  glottis  and  suffocation. 

Bromine  preparations  are  used  to  a  considerable  extent  in  photog- 
raphy. Schuler  "  describes  three  cases,  one  of  which  proved  fatal,  in 
men  who  prepared  "  brommetyl "  from  wood  alcohol  and  sulphuric 
acid.  In  all  of  these  three  cases  there  were  -pronounced  symptoms 
of  nausea,  spasms,  and  trembling  of  the  extremities  and  diminished 
bodily  temperature. 

TURPENTINE. 

Turpentine  vapors  in  excess  may  produce  gastric  and  pulmonary 
catarrh,  slow  and  painful  micturition  and  bloody  urine,  headache, 
roaring  in  the  ears,  and  other  nervous  symptoms.  Schuler  observed 
among  the  workers  in  calico  printing  marked  emaciation,  loss  of 
appetite,  rapid  pulse,  and  more  or  less  headache,  which  he  attributed 
to  the  turpentine  vapors.  In  small  doses  no  unpleasant  symptons  are 
observed.  The  odor  of  violets  in  the  urine  is  one  of  its  remarkable 
effects.  The  use  of  impure  turpentine  for  cleaning  purposes  has  been 
known  to  produce  obstinate  eczema  of  the  hand. 

PETROLEUM. 

Concentrated  vapors  of  coal  are  said  to  produce  loss  of  sensation, 
and  the  workmen  in  refineries  occasionally  show  symptoms  like  those 
observed  in  drunken  persons,  fall  into  a  profound  sleep,  or  suffer  from 
loss  of  memory,  dizziness,  headache,  and  chronic  bronchial  catarrhs. 
Pustular,  furuncular,  and  eczematous  affections  of  the  hands  are  also 
quite  common  in  persons  handling  this  and  paraffin  oil.  The  latter 
is  also  true  of  persons  handling  creosote  and  tar,  unless  protected  b}^ 
impermeable  gloves.  The  dangers  from  explosions  in  the  petroleum 
industry  must  also  be  guarded  against. 

BENZINE   VAPORS. 

Doctor  Neisser,  in  1907,  reports  an  instance  where  three  laborers 
in  a  carpet-cleaning  establishment  in  which  large  quantities  of  benzine 
had  been  used  were  found  unconscious  upon  the  floor  and  had  to  be 
restored  by  oxygen  inhalation.  The  toxic  symptoms  are  similar  to 
those  produced  by  concentrated  petroleum  vapors,  and  the  danger 
from  explosions  and  fire  are  of  course  even  greater. 

CARBON   MONOXIDE. 

Carbon  monoxide,  or  coal  gas,  when  present  in  sufficient  amount, 
paralyzes,  so  to  speak,  the  red  corpuscles  by  depriving  them  of  their 
oxygen  and  combining  with  the  ha3moglobin,  which  results  in  de- 

«  Deutsche  Viertelj.  f.  ceff.  Gesundheitpflege,  Bd.  31,  p.  696. 


EEPORTS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  59 

ficiency  of  oxygen  in  the  blood  and  serious  toxic  symptoms,  which 
may  end  in  death  by  producing  a  rapid  parenchymatous  degeneration 
of  the  liver,  spleen,  and  heart.  This  gas  is  often  present  in  gas  and 
smelting  works  and  around  coke  or  charcoal  furnaces,  and  one- fourth 
per  cent  by  volume  in  the  air  will  produce  toxic  symptoms,  and  more 
than  1  per  cent  is  rapidly  fatal  to  animal  life.  The  workmen  some- 
times, though  not  as  often  as  is  supposed,  suffer  from  the  chronic 
form  of  poisoning,  such  as  headache,  dizziness,  slow  pulse,  ansemia, 
general  debility,  and  diseases  of  the  respiratory  and  digestive  organs. 
The  acute  symptoms  of  coal-gas  poisoning  are  increased  respiration 
and  pulse,  violent  headache,  dizziness,  and  roaring  in  the  ears. 
These  are  soon  followed  by  symptoms  of  depression,  nausea  and 
vomiting,  numbness,  drowsiness,  muscular  relaxation,  paralysis,  sigh- 
ing respiration,  slowness  of  the  pulse  and  feeble  heart  action,  dila- 
tation of  the  pupils,  diminished  bodily  temperature,  and,  if  continued, 
convulsions,  stertorous  breathing,  and  death  by  suffocation.  If  deaih 
does  not  occur,  the  patient  is  apt  to  suffer  for  some  time  from  head- 
ache, physical  and  mental  depression,  paralysis  of  speech  and  of  the 
sphincters,  convulsive  twitching,  and  general  muscular  weakness, 
while  pleurisy  and  pneumonia  are  also  frequent. 

CARBONIC-ACID  GAS. 

The  chronic  effect  of  carbonic-acid  gas  has  already  been  alluded 
to.  Well  sinkers  and  miners  are  occasionally  suffocated,  owing  to 
the  presence  of  a  large  volume  of  this  gas  evolved  from  the  soil  and 
which  has  collected  in  deep  shafts.  It  is  one  of  the  constituents  of 
the  "  choke  damp  "  in  the  mines  and  also  present  in  cellars.  It  is 
also  a  product  of  fermentative  processes,  and  the  anaemic  and  de- 
bilitated conditions  of  miners,  vintners,  distillers,  brewers,  and  yeast 
makers  is  believed  to  be  partlj^  due  to  an  excess  of  carbonic  acid, 
which  diminishes  the  amount  of  oxygen  in  the  air.  The  acute  symp- 
toms are  loss  of  consciousness  and  locomotion,  generally  preceded  by 
difficulty  in  breathing,  headache,  depression,  drowsiness  or  mental 
excitement,  sometimes  convulsions.  Prompt  removal  of  the  patient 
into  fresh  air  will  lead  to  rapid  recovery. 

CARBON   DISULPHIDE. 

Carbon  disulphide  is  used  in  certain  processes  in  the  manufacture 
of  vulcanized  india  rubber,  and  also  in  the  extraction  of  fats,  and  may 
produce  in  those  constantly  exposed  to  it  headache,  dizziness,  im- 
paired vision,  pains  in  the  limbs,  formication,  sleeplessness,  nervous 
depression,  loss  of  appetite,  etc.  Sometimes,  according  to  Delpech 
and  Hirt,  there  is  cough,  febrile  attacks,  deafness,  difficult  breathing, 
loss  of  memory,  paralysis  of  the  legs  and  lower  part  of  the  body, 
loss  of  sexual  power,  which  has  been  preceded  by  increased  sexual 
appetite  and  mental  exaltation. 

NAPHTHA. 

Naphtha  is  used  in  the  same  industries,  and  it  is  not  improbable 
that  the  symptoms  are  produced  by  the  combined  influence  of  the 
two  fumes.    At  all  events,  there  are  a  number  of  authenticated  cases 


go  REPOKTS   OF    THE   PRESIDENT'S   HOMES   COMMISSION. 

of  acute  naphtha  poisoning  cliaracterized  by  dyspnoea,  dizziness,  and 
mental  confusion,  with  vomiting,  palpitation  of  the  heart,  and  hem- 
orrhages in  the  fatal  cases.  Necropsies  reveal  evidence  of  fatty 
degeneration  of  the  heart,  liver,  kidneys,  and  other  parts.  The 
cleaners  of  woolen  goods,  etc.,  with  naphtha  not  infrequently  suffer 
from  dizziness,  nausea,  vomiting,  headache,  sleeplessness,  hysteria, 
and  symptoms  resembling  alcoholic  intoxication.  {See  also  Dyeing 
and  cleansing.) 

NITROBENZOL. 

Nitrobenzol,  which  is  used  in  making  aniline  and  in  the  manu- 
facture of  roburite  and  other  explosives,  produces  headache,  dyspnoea, 
drowsiness,  dizziness,  nausea  and  vomiting,  great  depression,  stupor, 
and  often  terminates  fatally. 

The  majority  of  workers  in  dinitro  compounds  in  Great  Britain  « 
are  anaemic  and  suffer  from  difficulty  in  breathing  and  general  weak- 
ness. They  are  subject  to  a  biweekly  medical  inspection  and  are 
enjoined  (1)  not  to  touch  these  compounds  with  bare  hands;  (2)  to 
keep  the  feet  in  good  condition  (a)  by  bathing,  (5)  by  shoes  in  good 
repair;  (3)  avoidance  of  alcoholic  beverages;  and  (4)  by  thorough 
washing  of  the  hands  before  eating  and  change  of  clothing  upon 
quitting  the  work. 

DYEING   AND   CLEANSING. 

Among  the  chemical  substances  employed  are  naphtha,  gasoline, 
wood  alcohol,  ammonia,  various  acids,  bleaching  agents,  iron,  copper, 
and  other  salts,  aniline  dyes  and  other  dyestuffs. 

The  Massachusetts  board  of  health  reported  of  one  large  estab- 
lishment investigated: 

In  the  naphtha-cleansing  department,  in  spite  of  mechanical  ventilation,  there 
is  a  strong  odor  of  naphtha,  and  all  of  the  men  here  employed  are  pale  and 
some  of  them  very  markedly  sick  looking.^  In  the  room  in  which  the  naphtha- 
cleansed  goods  are  dried,  at  a  temperature  of  about  120°  F.,  the  naphtha  fumes 
are  very  strong.  Although  the  men  who  bring  in  the  goods  remain  but  a  few 
minutes,  some  have  occasionally  been  temporarily  overcome  by  the  fumes  and 
have  shown  the  characteristic  excitement  and  hysterical  symptoms  of  naphtha 
intoxication.  At  the  time  of  visit,  the  man  who  does  most  of  this  work  had 
been  engaged  thereat  for  three  months  and  had  experienced  no  ill  effects. 

RUBBER  INDUSTRY. 

The  Massachusetts  board  of  health  investigated  14  rubber  factories 
with  about  9,000  employees."  It  appears  that  naphtha  has  to  a  ^reat 
extent  replaced  the  more  dangerous  carbon  disulphide  as  a  vulcanizing 
agent,  and  in  11  of  the  13  factories  visited  the  odor  of  naphtha  was 
noted  as  only  slight.  In  two  factories  it  was  stated  that  "  a  few  girls, 
new  to  the  work,  show  the  effects  of  naphtha  and  suffer  from  headache 
and  sometimes  nausea  and  vomiting,  but  that  such  girls  do  not  long 
continue  at  the  work.  Naphtha  fumes  sometimes  bring  about  a  condi- 
tion which  much  resembles  alcoholic  intoxication,  and  which  occurs 
most  often  in  the  room  where  rubber  is  spread  upon  cloth.  New  men  are 

«  Cited  by  Neisser,  1907,  p.  79. 

»  Report  of  the  State  Board  of  Health  of  Massachusetts,  1907,  p.  109. 

•  Report  of  the  State  Board  of  Health  of  Massachusetts,  1907,  p.  113. 


EEPOETS   OF   THE  PKESIDENt's  HOMES   COMMISSION.  61 

especially  susceptible,  but  even  old  hands  have  sometimes  to  leave  their 
work  at  times  for  a  breath  of  fresh  air.  *  *  *  In  6  of  the  factories 
where  litharge  is  handled,  no  history  could  be  obtained  of  any  case  of 
lead  poisoning.  In  two  it  was  stated  that  cases  occur,  but  not  often. 
All  of  the  establishments,  with  one  exception,  were  found  to  be  well 
lighted  and  adequately  ventilated." 

PATENT-LEATHER  INDUSTRY. 

The  fumes  of  naphtha,  amyl  acetate,  and  wood  alcohol,  which  are 
given  off  in  the  manufacture  of  patent  leather,  are  dangerous.  While 
no  exact  data  are  available,  it  is  admitted  by  those  in  authority  that 
many  employees  can  not  do  the  work  on  account  of  inability  to  with- 
stand their  influences. 

ANILINE  VAPOR. 

Aniline  vapor  is  dangerous  to  health  when  present  in  the  air  to  the 
extent  of  0.1  per  cent.  Hirt  describes  an  acute  form  of  poisoning  from 
aniline  vapor,  which  usually  results  fatally.  "The  workman  falls 
suddenly  to  the  ground,  the  skin  is  cold  and  pale,  the  face  is  cyanotic 
(bluish  discoloration  of  the  skin),  the  breath  has  the  odor  of  aniline, 
the  respiration  is  slowed,  and  the  pulse  increased.  The  sensation 
diminishes  from  the  beginning  of  the  attack,  gradually  entirely  dis- 
appears, and  death  follows  in  a  state  of  profound  stupor." 

The  milder  forms  are  characterized  by  laryngeal  irritation,  loss  of 
appetite,  headache,  giddiness,  and  weakness,  with  a  rapid,  small,  and 
irregular  pulse,  and  diminished  sensibility  of  the  skin.  In  some 
instances  short  convulsions  have  occurred.  Prompt  fresh-air  treat- 
ment is  absolutely  essential. 

The  chronic  form  of  aniline  poisoning  may  affect  the  central 
nervous  system,  and  cause  lassitude,  headache,  roaring  in  the  ears, 
motor  or  sensory  disturbance,  or  it  may  produce  digestive  derange- 
ments such  as  eructations,  nausea,  and  vomiting,  or  it  may  affect  the 
skin  by  causing  eczematous  or  pustular  eruptions  and  even  well- 
defined  ulcers.  Doctor  Neisser  (1907)  reports  a  number  of  such  cases 
either  in  aniline  factories  or  in  dyeing  works. 

The  medical  inspector  of  Clayton,  England,  has  presented  a  very 
interesting  report  °  on  the  effects  of  aniline  oil  in  black  aniline  dyeing 
works,  and  also  the  effects  upon  the  skin  of  chromic  acid  and  the 
bichromates  of  potassium  and  sodium  in  these  establishments.  He 
visited  20  establishments  and  examined  200  employees,  many  of  whom 
suffered  from  anaemia,  headache,  digestive  derangements,  heartburn, 
dizziness,  palpitation  of  the  heart,  loss  of  will  power,  and  excessive 
mucous  secretions,  all  of  which  were  attributed  to  the  toxic  effects  of 
aniline.  He  recommends  as  safeguards:  (1)  Mechanical  suctional 
ventilation  (a)  at  the  machines  where  the  cloth  is  being  dyed,  (5)  at 
the  machines  where  the  cloth  passes  through  the  bichromate  solution, 
and  (c)  at  joints  where  there  is  danger  from  the  chromate  dust;  (2) 
protective  clothing,  and  frequent  washing  of  the  working  suits,  lockers, 
and  dressing  rooms  for  street  clothing;  (3)  special  lunch  rooms;  (4) 
suitable  wash  rooms.^ 

o  Neisser,  p.  75,  1907. 
*_Cited  by  Neisser,  p.  74. 


62  EEPORTS   OP   THE  PRESIDENT'S  HOMES  COMMISSION. 

WOOD   ALCOHOL. 

Vapors  from  varnishes  have  been  known  to  produce  blindness,  due 
to  inflammation  of  the  nerves  behind  the  eyeball,  and  partial  atrophy 
of  the  optic  nerve.  Similar  effects  follow  the  internal  use  of  wood 
alcohol,  and  even  fatal  cases  have  been  reported  in  consequence  of  its 
substitution  for  pure  alcohols.  Doctor  Neisser,  in  1907,  reports  a  large 
number  of  eczema tous  affections  of  the  hands,  arms,  and  face  in 
furniture  polishers  ("  polisher's  itch  "),  which  may  possibly  be  caused 
by  some  of  the  impure  alcohols. 

CHROME    PIGMENTS. 

In  the  manufacturing  and  handling  of  chrome  pigments,  as  in  tan- 
neries and  various  leather  industries,  a  dust  or  vapor  is  involved 
which  causes  inflammation  of  the  eyes  and  even  ulceration  of  the 
nasal  septum  and  elsewhere. 

QUININE. 

Quite  a  large  percentage  of  the  persons  employed  in  the  manufac- 
ture of  quinine  suffer  from  a  dry  form  of  eczema  of  the  hands  and 
face,  which  is  claimed  to  be  directly  due  to  emanations  from  the  boil- 
ing solution,  as  the  disease  disappears  if  the  work  is  given  up. 

In  the  so-called  "  polisher's  itch  "  and  in  the  effects  produced  by 
chrome  and  quinine  the  use  of  rubber  gloves  and  annointing  the 
skin  with  some  clean  oil  or  grease  have  been  found  most  useful. 

MANGANESE. 

According  to  Doctor  Neisser  (1907)  a  small  percentage  of  the 
workers  in  manganese  mills  and  dry  pigments  are  affected  with  head- 
ache, dizziness,  loss  of  appetite,  constipation,  loosening  of  the  teeth, 
muscular  pains,  and  general  debility. 

BRASS    FOUNDERS. 

The  workers  in  brass  foundries  inhale  a  metallic  dust  or  vapor  of 
zinc  or  copper,  or  perhaps  of  both,  which  has  given  rise  to  a  train  of 
symptoms  described  as  "brass  founders'  ague."  The  illness  attacks 
about  75  per  cent  of  those  who  are  new  to  the  work,  or  who  resume 
work  after  an  absence  of  a  month  or  even  a  fortnight.  There  are 
more  or  less  severe  pains  in  the  back,  and  general  lassitude,  which 
compels  the  patient  to  seek  his  bed.  Usually  after  he  has  taken  to  his 
bed  chilliness  comes  on,  increasing  to  a  decided  rigor  and  lasting 
fifteen  minutes  or  longer.  In  the  course  of  an  hour  or  less  the  pulse 
beats  from  100  to  120  per  minute,  accompanied  by  a  tormenting 
cough,  corresponding  headache,  and  soreness  in  the  chest.  After  the 
lapse  of  a  few  hours  free  perspiration  indicates  the  disappearance  of 
the  fever  and  the  patient  falls  into  a  deep  sleep,  from  which  he 
awakens  with  perhaps  only  a  slight  headache  and  lassitude.  In 
England  the  men  who  suffer  this  way  drink  freely  of  milk  and  pro- 
mote vomiting — perhaps  the  best  treatment  for  copper  or  zinc  poison- 
ing.   A  chronic  form  of  zinc  or  copper  poisoning,  characterized  by 


REPORTS    OP   THE   PRESIDENT'S   HOMES   COMMISSION.  63 

oversensibility,  formication,  and  burning  of  the  skin  of  the  lower  ex- 
tremities, tactile  and  motor  disturbance,  anaemia,  cough,  headache, 
neuralgia,  digestive  disturbance,  and  progressive  emaciation,  is  said 
to  occur  among  men  who  have  worked  for  a  number  of  years  in  brass 
foundries.  At  present  it  is  not  possible  to  say  whether  the  symptoms 
of  brass  founders'  ague  are  due  to  the  copper,  zinc,  or  arsenic,  or  a 
combination  of  all  three.  Some  authors  believe  it  to  be  a  specific 
infection. 

ARSENICAL.   FUMES. 

Arsenical  fumes  ure  frequently  given  off  in  smelting  processes, 
especially  copper  works,  and,  like  those  of  arseniuretted  hydrogen, 
may  give  rise  to  jaundice,  headache,  nausea,  stiffness  of  the  joints, 
general  anaemia,  discomfort,  and  malnutrition.  When  inhaled  in  con- 
centrated doses  the  fumes  produce  symptoms  of  nausea,  vomiting, 
languor,  drowsiness,  rapid  pulse,  frequent  micturition,  and  bloody 
urine.  In  serious  cases  the  pulse  becomes  small  and  thready,  skin  cold 
and  clammy,  and  death  ensues  with  evident  signs  of  cardiac  paralysis. 

MERCURY. 

The  most  important  of  the  poisonous  vapors  in  connection  with 
dangerous  trades  are  mercury  and  phosphorus.  Workers  in  mercury 
suffer  greatly  from  the  effects  of  mercurial  poisoning,  such  as  saliva- 
tion, tremor  and  nervous  symptoms,  and  many  fall  victims  to  pul- 
monary tuberculosis.  Miscarriages  among  the  female  employees  are 
very  common.  These  effects,  according  to  Renk,**  are  due  to  the  in- 
halation of  mercurial  vapors  in  badly  ventilated  workshops,  while 
Wollner  attributes  them  to  the  inhalation  and  swallowing  of  fine 
mercurial  dust.  Of  7,221  mirror  makers  at  Furth  during  the  year 
1883,  not  less  than  2,457,  or  34  per  cent,  were  taken  sick,  and  of  these 
60  per  cent  suffered  from  mercurial  poisoning.  This  danger  has  been 
practically  eliminated  in  the  mirror  industry,  but  it  is  still  pronounced 
in  the  manufacture  of  felt,  thermometers,  barometers,  dry  electric 
batteries,  and  bronzing.  In  Europe  persistent  efforts  are  being  made 
to  reduce  the  danger  in  these  industries  to  a  minimum,  and  some  of  the 
felt  establishments  no  longer  use  the  preliminary  treatment  of  the  hair 
with  mercuric  nitrate.  The  64  cases  reported  in  Great  Britain  in 
1906  and  cited  by  Neisser  occurred  as  follows:  Manufacturers  of 
electric  meters,  17;  thermometers,  etc.,  16;  felt  and  fur  industry,  13; 
gilding,  7 ;  chemical  works,  7 ;  pow^der  works,  3 ;  lithography,  1. 

As  preventive  measures  may  be  mentioned  the  following:  (1) 
Change  of  clothing  before  and  after  work;  (2)  weekly  washing  of 
the  working  clothes;  (3)  systematic  and  frequent  washing  of  the 
hands,  weekly  sulphur  baths  or  frequent  general  baths,  and  gargling 
at  the  close  of  work  with  a  solution  of  permanganate  of  potassium: 
(4)  limit  of  Avork  to  eight  hours  per  day  and  thorough  ventilation 
of  the  rooms — open  doors  and  windows;  (5)  frequent  cleaning  of 
floors  with  damp  sawdust  and  sprinkling  with  a  solution  of  ammonia. 

•Renk  Arbeiteii  aus  dem  k.  k.  Gesimdlieitsamte,  V.  p.  113. 


64  BEPORTS  OF  THE  PRESIDENT'S  HOMES  COMMISSION. 

PHOSPHORUS. 

In  the  manufacture  of  phosphorus  matches  white  and  red  phos- 
phorus have  been  used.  The  danger  consists  in  the  inhalation  of  the 
fumes  when  the  white  substance  is  used,  while  the  red  or  amorphous 
phosphorus  is  neither  poisonous  nor  easily  inflammable.  The  gas 
smells  like  garlic.  The  toxic  symptoms  in  the  acute  form  are  difficult 
breathing  and  a  feeling  of  intense  anxiety.  The  fumes  are  only  given 
off  when  the  air  contains  moisture.  The  milder  effects  of  phosphorus 
consist  of  gastric  and  bronchial  catarrhs,  anaemia,  and  malnutrition, 
followed  occasionally  by  a  painful  inflammation  of  the  bones  of  the 
lower  or  upper  jaw,  due  to  the  local  action  of  the  phosphorus,  and 
often  beginning  in  carious  teeth  or  in  the  alveolar  process  of  missing 
teeth.  The  disease  may  develop  during  the  first  months,  but  generally 
not  until  four  or  five  years  after  the  beginning  of  the  employment, 
and  carious  teeth,  with  toothache,  are  among  the  first  symptoms,  fol- 
lowed by  swelling  of  the  glands  of  the  neck,  alveolar  abscesses,  and 
necrosis  of  the  jaws.  Formerly  from  11  to  12  per  cent  of  the  employees 
suffered.  Since  the  use  of  red  or  amorphous  phosphorus  the  danger 
has  been  greatly  reduced.  Only  about  2  per  cent  of  the  operatives  are 
now  attacked. 

Doctor  Neisser  reports  that  during  the  year  1906  several  cases  of 
phosphorus  necrosis  occurred  in  German  match  factories,  in  which 
the  use  of  white  phosphorus  was  promptly  stopped. 

The  medical  inspectors  of  Great  Britain,  from  October  1,  1900,  to 
October  1,  1905,  reported  only  11  cases  of  phosphorus  necrosis,  the 
reduction  being  attributed  to  improved  factory  sanitation. 

The  medical  inspector  of  Belgium  (quoted  by  Doctor  Neisser,  page 
71)  reports  that  during  the  last  six  years  only  one  case  of  necrosis 
occurred,  and  the  morbidity  of  the  employees  in  match  factories  has 
also  decreased  coincident  with  factory  sanitation,  as  shown  by  the 
following  figures: 

1905. 

Employees 1,114  1,182  1,226 

Employees  examined 7,061  8,511  9,003 

Apparently  healthy  employees 757  1,055  1,061 

Sick  employees 387  127         165 

Deaths 401  132  (o) 

«  Doctor  Neisser  states  that  the  records  do  not  disclose  the  fact  whether  or  not  there 
were  any  deaths  during  1905. 

The  use  of  respirators,  thorough  ventilation,  the  disengagement  of 
turpentine  vapors  to  promote  rapid  drying  and  strict  cleanliness,  such 
as  ablution  of  the  hands,  change  of  clothing,  and  gargling  with  weak 
alkaline  solutions  before  eating  and  drinking  are  still  in  order  as  pre- 
ventive measures. 

BEET-SUGAR  INDUSTRY. 

In  the  beet-sugar  industry,  especially  when  the  diffusion  method  is 
employed,  an  explosive  mixture  containing  probably  carbureted 
hydrogen  has  proved  a  source  of  danger  to  the  operatives,  and  the 
waste  waters  are  believed  to  be  also  a  menace  to  public  health. 


1903. 

1904. 

1,114 

1,182 

7,061 

8,5n 

757 

1,055 

387 

127 

401 

132 

BEPOETS   OF   THE  PRESIDENT'S  HOMES  COMMISSION,  65 


Chapter  VI. 

OCCUPATIONS    INVOLVING    THE    INHALATION    OP    ORGANIC    GASES 

AND  VAPORS. 

Whether  the  effluvia  from  sewers,  stables,  stock  yards,  slaughtering 
and  packing  houses ;  glue,  candle,  and  soap  factories ;  hide  depots,  tan- 
neries, fertilizer-making  establishments,  etc.,  are  injurious  to  health 
remains  an  open  question.  Many  authors  insist  that  the  olfactory  or- 
gans are  alone  offended,  and  point  to  the  mortality  statistics,  which  in- 
dicate that  the  average  age  of  such  employees  is  quite  high.  Others 
hold  that  weaklings  rarely  engage  in  such  occupations,  and  that  the 
effluvia,  consisting,  as  they  do,  of  ammonia  and  sulphureted  gases,  are 
fully  as  injurious  as  the  inhalation  of  sewer  air,  which,  judging  from 
experiments  in  aViimals,  would  appear  to  increase  the  susceptibility  to 
infectious  diseases  by  diminishing  the  power  of  resistance.  Stift  main- 
tains that  hydrogen  and  ammonium  sulphides,  chiefly  derived  from 
decomposition  of  animal  matter  and  usually  present  in  privy  vaults, 
cesspools,  and  sewers,  are  blood  poisons  when  present  to  the  extent 
of  about  1 : 4,000  volumes  per  100.  The  same  author  believes  that  the 
inhalation  of  sulphureted  hydrogen  affects  directly  the  terminal  fila- 
ments of  the  pneumogastric  nerve,  and  through  these  sets  up  an  irrita- 
tion of  the  respiratory  and  cardiac  centers — in  fact,  of  the  entire 
medulla  oblongata — and  if  continued  sufficiently  long  induces  paraly- 
sis of  this  function. 

In  sewer  air  the  danger  is  intensified  by  the  excess  of  carbonic-acid 
gas  and  deficiencv  of  oxygen,  and  special  precaution  should  be  taken 
to  exhaust  the  foul  air  before  sewer  employees  or  scavengers  are 
allowed  to  descend. 

The  general  effects  of  the  foul  odors  upon  those  unaccustomed  to 
work  in  the  so-called  "  offensive  trades  "  are  nausea,  vomitings  head- 
ache, loss  of  appetite,  diarrhea,  a  general  depression,  and  weakness. 
It  is  true  the  workmen  become  gradually  accustomed  to  these  emana- 
tions without  any  apparent  injury,  but  even  this  does  not  justify  the 
assumption  that  they  are  of  no  consequence. 

Every  community  provides  for  the  collection  and  disposal  of  dead 
animals,  which  is  usually  done  by  contract,  and  the  animals  are  taken 
to  some  point  beyond  the  town  limits,  flayed,  and  worked  up,  so  as  to 
utilize  the  skin,  hair,  bones,  fats,  horns,  etc.  There  is,  however,  a 
certain  element  of  danger  from  the  transmission  of  infectious  diseases 
like  anthrax,  glanders,  and  tuberculosis,  and  hence  all  such  work 
should  be  done  under  strict  sanitary  control. 


Chapter  VII. 

OCCUPATIONS  INVOLVING  EXPOSURE  TO  EXTREMES  OF  HEAT,  SUD- 
DEN CHANGES,  AND  ABNORMAL  ATMOSPHERIC  PRESSURE. 

Exposure  to  extremes  of  heat  and  sudden  changes  is  injurious  and 
predisposes  to  a  number  of  diseases.     Stokers,  cooks,  bakers,  black- 
smiths, firemen,  etc.,  are  very  apt  to  suffer  from  heat  exhaustion  and 
thermic  fever  (sunstroke).    The  duration  of  life  is  low,  and  rheuma- 
S.  Doc.  644,  60-2 6 


66  EEPORTS   OF   THE  PRESIDENT'S   HOMES   COMMISSION. 

tism,  eczema,  catarrhal  affections,  pneumonia,  and  diseases  of  the  heart 
are  quite  common.  Sailors,  farmers,  motormen,  conductors,  teamsters, 
coachmen,  and  many  others  are  often  exposed  to  sudden  changes  in 
the  weather,  and  suffer  quite  frequently  from  rheumatism,  catarrhal 
affections,  pneumonia,  and  Bright's  disease. 

The  effects  of  both  heat  and  cold  are  intensified  by  extreme  humid- 
ity in  the  atmosphere,  and  special  precautions  are  necessary  upon  hot 
and  sultry  days  and  in  cold,  raw  weather.  Occupations  involving  ex- 
posure to  dampness,  especially  when  performed  indoors,  are  injurious, 
because  a  cold,  damp  air  abstracts  an  undue  amount  of  animal  heat 
from  the  body,  lowers  the  power  of  resistance,  and  predisposes  to 
catarrhal  and  rheumatic  diseases.  It  is  a  well-known  fact  that  damp 
houses  favor  the  development  of  consumption. 

CAISSON    DISEASE. 

I 

The  effects  of  compressed  air  on  workmen  in  tunnels,  caissons,  deep 
mines,  and  diving  bells  were  formerly  attributed  solely  to  increased 
atmospheric  pressure,  in  consequence  of  which  it  was  believed  that 
the  blood  received  not  only  an  excess  of  oxygen,  but  by  reason  of  the 
abnormal  pressure  was  driven  from  the  surface  to  the  internal  organ, 
causing  congestion,  especially  of  the  central  nervous  system.  It  is 
now  held  that,  while  increased  atmospheric  pressure  is  capable  of 
producing  characteristic  effects  upon  the  circulation,  such  as  pallor 
of  the  skin,  ringing  in  the  ears,  bulging  and  possibly  rupture  of  the 
ear  drums,  the  most  serious  symptoms  are  produced  when  the  pres- 
sure is  too  rapidly  increased  or  removed  by  a  faulty  method  of  "  lock- 
ing in  "  and  "  locking  out." 

A  commission  of  Belgian  medical  experts  examined  166  caisson 
workers  before  and  after  their  work,  the  shift  lasting  from  eight  to 
twelve  hours,  and  found  (1)  that  the  blood-making  function,  as 
shown-  by  the  haemoglobin  contents,  was  actually  increased  during 
their  work;  (2)  that  so  long  as  the  pressure  does  not  increase  be- 
yond 3  atmospheres  (45  pounds)  the  men  feel  perfectly  well  and 
perform  their  labor  with  more  ease  and  even  less  fatigue  than  under 
normal  atmospheric  pressure;  (3)  that  men  of  temperate  habits, 
with  a  sound  heart,  lungs,  and  nervous  system,  suffer  no  injurious 
effects,  and  none  others  should  be  employed;  (4)  the  real  injury 
is  done  by  a  sudden  removal  of  atmospheric  pressure  in  a  hasty 
"  locking-out "  process,  for  which  the  workmen  are  often  to  blame. 

The  general  rule  in  "  locking  out "  should  be  to  allow  at  least  one 
minute  for  each  6  pounds  of  pressure  within  the  chamber. 

The  symptoms  of  so-called  caisson  disease  are  rarely  observed  until 
the  pressure  equals  20  pounds,  and  usually  do  not  appear  for  some 
minutes  or  hours  after  emerging.  In  addition  to  the  symptoms 
already  mentioned,  there  may  be  hemorrhage  from  the  nose,  mouth, 
and  ears;  headache,  dizziness,  rapid  pulse,  sweating,  severe  pain  in 
the  back,  extremities,  or  region  of  the  stomach,  and  vomiting.  Par- 
tial deafness  and  symptoms  of  motor  paralysis,  more  or  less  general, 
but  most  frequently  confined  to  the  lower  extremities,  are  frequently 
observed.  Cases  with  pronounced  head  and  spinal  symptoms  usually 
prove  fatal.  The  milder  cases,  as  a  rule,  recover  sooner  or  later, 
although  the  muscular  pains  and  paralytic  symptoms  may  persist  for 
weeks,  or  even  longer. 


REPORTS    OF   THE   PRESIDENT'S   HOMES   COMMISSION.  67 

Chapter  VIII. 
OCCUPATIONS  INVOLVING  CONSTRAINED  ATTITUDES. 

The  effects  of  a  constrained  j)osition,  combined  with  a  sedentary 
life,  are  very  injurious.  This  is  especially  seen  in  weavers,  shoe- 
makers, engravers,  watchmakers,  tailors,  lithographers,  etc.,  all  of 
whom  are  obliged  to  assume  a  more  or  less  constrained  attitude, 
which  interferes  with  a  proper  distribution  of  the  blood  supply  and 
is  liable  to  be  followed  by  internal  congestions.  But  perhaps  the 
greatest  harm  results  from  deficient  movement  of  the  chest  and  con- 
sequent interference  with  normal  respiration.  As  a  matter  of  fact, 
many  of  these  artisans  suffer  from  phthisis,  constipation,  dyspepsia, 
and  hemorrhoids,  and  all  have  a  low  average  duration  of  life. 

Among  the  apprentices  of  bakers,  deformities  such  as  "  flat  foot " 
and  "  knock-knee  "  and  varicose  veins  of  the  lower  extremity  are  fre- 
quently seen,  as  the  result  of  being  on  their  feet  too  long.  Varicose 
veins  and  ulcers  are  quite  common  among  motormen  and  conductors, 
while  bakers,  cabinetmakers,  and  others  are  also  very  liable  to  de- 
velop abnormal  curvature  of  the  spine. 

Chapter  IX. 

OCCUPATIONS     INVOLVING     OVEREXERCISE     OF     PARTS     OF     THE 

BODY. 

Among  the  diseases  due  to  the  excessive  use  of  certain  muscles  may 
be  mentioned  the  affection  called  "  writer's  cramp,"  which  is  a  con- 
vulsive affection  of  the  fingers.  Similar  fatigue  neuroses,  character- 
ized by  localized  paralysis  and  twitching,  are  observed  in  copyists, 
typewriters,  telegraph  operators,  pianists,  violinists,  engravers,  seam- 
stresses, cigar  makers,  etc. 

Pulmonary  emphysema  is  quite  common  among  performers  on 
wind  instruments.  Boiler  makers'  deafness  and  mill  operatives'  deaf- 
ness may  also  be  mentioned.  The  former  is  believed  to  be  due  to  their 
constant  exposure  to  an  atmosphere  in  a  state  of  violent  vibration, 
while  the  latter  affection  is  characterized  by  an  inability  to  hear  dis- 
tainctly  except  during  a  noise.  Public  speakers  and  singers  are  apt 
to  suffer  from  chronic  affections  of  the  throat  and  paralysis  of  the 
vocal  chords,  and  watchmakers,  engravers,  and  seamstresses,  as  well 
as  all  others  who  use  their  eyes  upon  minute  objects,  are  more  liable 
to  suffer  from  nearsightedness  and  other  visual  defects. 

Tobacco  testers  are  apt  to  suffer  from  nervous  symptoms  and  seri- 
ous visual  defects,  and  tea  tasters  soon  become  the  victims  of  muscu- 
lar tremblings  and  other  nervous  symptoms,  the  result  of  a  chronic 
"  theine  intoxication." 

Chapter  X. 

OCCUPATIONS    INVOLVING    EXPOSURE    TO    MxVCHINERY,    ETC. 

Life  insurance  and  accident  policy  statistics  plainly  indicate  the 
danger  of  occupations  which  involve  contact  with  machinery.  This 
may  be  the  result  of  individual  carelessness  or  the  negligence  of 
others.     Not  infrequently  accidents  are  the  result  of  boiler  explo- 


68  REPORTS  OP  THE  PRESIDENT'S  HOMES  COMMISSION. 

sions,  circular  saws,  belting,  and  flying  fragments,  and  are  due  to  a 
lack  of  proper  safety  devices.  ^  As  might  be  expected,  many  of  the 
accidents  befall  children  and  inexperienced  persons  and  take  place 
at  night  or  in  badly  lighted  establishments.  Roth  calls  attention  to 
the  accident  statistics  of  the  German  Empire  for  1897,<»  which 
clearly  indicate  that  accidents  increase  with  mental  and  muscular 
fatigue.  Upon  the  assumption  that  there  is  one  accident  for  every 
three  working  hours  during  the  year,  the  average  number  of  indus- 
trial accidents  in  the  forenoon  between  6  and  9  o'clock  was  1.10; 
between  9  and  12  o'clock,  2.26;  in  the  afternoon  between  12  and  3 
o'clock  it  was  1.02 ;  between  3  and  6  o'clock,  2.11. 

Professor  Imbert  at  the  International  Congress  for  Hygiene  and 
Demography  at  Brussels,  1903,  from  an  abundance  of  statistical 
material  arrived  at  a  similar  conclusion.  According  to  Rubner '' 
of  100  accidents,  41  befell  children  under  15  years  of  age,  36.4  befell 
persons  between  15  and  25  years  of  age,  13.1  befell  persons  between 
25  and  40  years  of  age,  and  9.5  befell  persons  between  40  and  60 
years  of  age.  The  upper  extremities  were  involved  in  87  per  cent  of 
the  cases,  the  lower  extremities  in  7.5  per  cent,  and  the  head  and 
trunk  in  5.5  per  cent.  During  the  year  1899  there  were  in  English 
factories  301  fatal  and  19,321  nonfatal  accidents,  all  attributable  to 
machinery  moved  by  mechanical  power.*' 

Swiss  statistics  show  that  among  1,000  workingmen  accidents  occur 
as  follows:**  Cotton  spinners,  2.22;  millers,  28;  paper  manufac- 
turers, 31.1;  carpenters,  35.2;  locksmiths,  46.9;  brewers,  66.7;  masons, 
80.5;  blacksmiths,  93.1;  metal  workers,  102.1;  molders,  132.2. 

According  to  the  New  York  State  statistics,  cited  by  Hoffman,* 
for  the  five  years  ending  with  1905,  there  occurred  in  the  metal  trades 
in  that  State  8,456  accidents,  of  which  135,  or  1.6  per  cent,  were 
fatal,  6,397  caused  temporary  disablement,  and  1,306  resulted  in  per- 
manent disablement.  In  the  chemical  industries  during  the  same 
period  there  occurred  1,339  accidents,  of  which  33,  or  2.5  per  cent, 
were  fatal.  Of  the  total  number  91.1  per  cent  caused  temporary 
disablement,  and  6.3  per  cent  permanent  disablement. 

Many  of  the  accidents  to  metal  workers,  masons,  miners,  weavers, 
etc.,  befall  the  eye,  and  Magnus  attributes  8.5  per  cent  of  all  cases  of 
blindness  to  accidents. 

Of  48,262  accidents  among  British  miners  from  1884  to  1898,  not 
less  than  2,506,  or  5.19  per  cent,  affected  the  eye.' 

COAL   MINING. 

The  mining  of  coal  is,  even  under  the  best  conditions,  one  of  the 
most  dangerous  industries.  A  report  of  the  United  States  Geolog- 
ical Survey  o  shows  the  number  of  men  killed  for  each  1,000  employed 

oErmuedung  diirch  Berufsarbeit,  Internat.  Kongress  fner  Hygieue  und 
Demographie,  Berlin  1907,  Band  li,  p.  618. 

»  Lehrbuch  der  Hygiene,  6th  ed.  T^ipzig  &  Wien,  1899-1900,  p.  701. 

'^  Dangerous  Trades,  Oliver,  p,  203. 

<*Bergey's  Principles  of  Hygiene,  1904,  p.  276. 

«  Bulletin  of  the  Bureau  of  I^bor  No.  78,  September,  190S. 

^Oliver,  p.  776. 

^Coal-Mine  Accidents;  Their  Causes  and  Prevention.  A  pnMiminary  Statis- 
tical Report    United  States  Geological  Survey,  1907. 


REPORTS   OF   THE  PRESIDENT  S  HOMES  COMMISSION. 


69 


in  the  United  States  and  in  the  four  leading  European  countries,  the 
figures  being  averages  for  five  years. 

Number  of  men  killed  for  each  1,000  men  employed — Averages  for  five  years. 


Country. 


Number. 


France  (1901-1905) 

Belgium  (1902-1906) 

Great  Britain  (1902-1906)  . 

PrusHia)  1900-1904 ) 

United  States  (1902-1906). 


0.91 
1.00 
1.28 
2.06 


The  following  table  from  the  same  report  shows  the  number  of 
deaths  from  accident  for  every  1,000,000  tons  of  coal  mined : 


Number  of  men 

killed  in 

coal  mines 

per  1,000,000  tons  of  coal  produced. 

Year. 

United 
States. 

Great 
Britain. 

Belgium. 

France. 

1902      ..                    ...            .                         .            

6.79 
5.62 
6.24 
5.97 
5.57 

6.29 
6.68 
6.66 
5.64 
4.96 

44.80 

1903 

O4.70 
4.41 
4.64 
4.31 

.20 

1904 

4.55 

1905                

4.17 

1906 

•Average,   1894  to   1903. 

The  causes  of  the  fatal  and  nonfatal  accidents  in  the  coal  mines  of 
the  United  States  in  1906  were  as  follows: 

Causes  of  coal-mine  accidents  in  the  United  States,  1906. 


Accidents  due  to— 

Killed. 

Injured. 

Gas  and  dust  explosions                        

228 

80 

1,008 

732 

307 

215 

Falls  of  roof  and  coal 

1,863 

2,192 

An  exhaustive  analysis  of  mining  accidents  in  the  German  Empire 
will  be  found  in  the  Statistik  der  Knappschafts-Berufsgenossenschaft 
fur  das  Deutsche  Reich,  Berlin,  1897.  The  total  number  of  persons 
insured  for  one  year  during  the  period  covered  (October  1,  1885,  to 
December  31,  1894)  by  the  work  was  3,623,175;  the  total  number  of 
accidents  of  all  kinds  notified  was  278,371,  distributed  as  follows : 

Total  number  of  accidents  of  all  kinds  notified. 


Class  of  accidents. 

Number. 

Per  1,000 
persons 

em- 
ployed. 

Fatal  accidents 

7,721 

1,427 

14, 367 

8,164 

2.13 

Accidents  causing  total  permanent  disability 

.89 

8.97 

2.25 

Minor  accidents  .•                           ... 

31,679 
246, 692 

8.74 
68.09 

Total 

278,371 

76.88 

70  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

The  causes  of  the  fatal  and  serious  accidents  as  calculated  per  1,000 
employees  are  given  as  follows : 

Falls  of  rock,  coal,  falling  bodies,  etc 3.44 

Transport,  haulage,  winding,  loading,  etc 2.  26 

Falls  from  ladders,  steps,  or  other  heights .  89 

Explosions .78 

Machinery  in  motion,  motors,  etc .  51 

Molten  metal,  hot  and  corrosive  fluids,  poisonous  gases .  12 

Miscellaneous .  74 

Total 8. 74 

Mr.  Henry  Louis,  in  commenting  upon  these  statistics  in  Oliver's 
"  Dangerous  Trades,"  page  516,  says : 

Forty-one  and  six-tenths  per  cent,  or  two-fifths,  of  all  the  accidents  could  have 
been  avoided  by  proper  care  and  intelligent  thought  on  the  part  of  all  con- 
cerned, and,  in  the  second  place,  fully  one-third  of  the  accidents  can  be  ascribed 
to  the  faults  of  the  victims  themselves. 

According  to  Revue  Scientifique  «  during  the  past  fifty  years  there 
were  no  less  than  503  mine  explosions  in  Europe,  with  a  loss  of  over 
5,000  lives.  The  number  of  men  killed  in  the  coal  mines  of  the  United 
States  is  appalling,  amounting  to  22,840  during  the  seventeen  years 
ending  with  1906.  In  1906  the  total  killed  was  2,061  and  about  5,000 
injured. 

In  the  introduction  to  the  Report  of  the  United  States  Geological 
Survey,  already  cited,  on  "Coal  Mine  Accidents:  Their  Cause  and 
Prevention,"  *  Mr.  Joseph  A.  Holmes  says : 

The  figures  given  in  this  report  indicate  that  during  the  year  1906  nearly  7,000 
men  were  killed  or  injured  in  the  coal  min^s  of  this  country,  and  that  the 
number  of  these  accidents  caused  directly  or  indirectly  by  mine  explosions  has 
been  steadily  increasing.  *  *  *  The  increase  both  in  the  number  and  in 
the  seriousness  of  mine  explosions  in  the  United  States  during  the  past  years 
may  be  expected  to  continue  unless,  through  investigations  made  in  the  United 
States,  such  as  have  proved  effective  in  other  coal-producing  countries,  informa- 
tion can  be  obtained  and  published  concerning  the  explosives  used,  the  condi- 
tions under  which  they  may  be  used  safely  in  the  presence  of  coal  dust  or  gas, 
and  the  general  conditions  which  make  for  health  and  safety  in  coal-mining 
operations. 

According  to  English  data,  cited  by  Frederick  L.  Hoffman  (Quar- 
terly Publications  of  the  American  Statistical  Association,  December, 
1902,  p.  178),  "  for  the  period  1890-1892,  at  ages  45  to  54,  the  general 
death  rate  of  all  miners  was  19.6  per  1,000,  and  of  quarrymen  25.3 
per  1,000.  For  coal  miners  alone  the  death  rate  at  this  age  period 
was  19.4 ;  for  copper  miners,  24.3 ;  for  tin  miners,  32.2,  and  for  lead 
miners,  23.9  per  1,000 — indications  of  quite  considerable  differences  in 
the  mortality  and  specific  disease  liability  of  men  engaged  in  the 
mining  of  coal  and  the  different  metals." 

While  tuberculosis  is  comparatively  rare  among  coal  miners,  an- 
thracosis  (a  lung  disease  produced  by  coal  dust — "black  lung"), 
miner's  asthma,  which  is  really  a  chronic  bronchitis  with  emphysema, 
and  simple  chronic  bronchitis  are  common  affections.  These  diseases 
are  largely  influenced  by  defective  ventilation,  for  Greenhow  has 
shown  that  in  the  operatives  of  well-ventilated  mines  there  is  no 
excess  of  pulmonary  diseases.*' 

« 1875,  II,  p.  765. 
^  Page  4. 

°  Greenhow,  third  and  fourth  report  of  the  medical  officer  of  the  privy  coun- 
cU,  1860-1861. 


REPOETS    OF    THE  PRESIDENT'S  HOMES   COMMISSION.  71 

Apart  from  large  quantities  of  dust,  the  air  of  mines  contains 
putrefactive  gases  from  decomposing  excrementitious  matter,  prod- 
ucts of  combustion,  especially  carbonic-acid  gas,  which  is  also  one  of 
the  constituents  of  the  "  choke  damp."  In  addition  to  all  this,  the 
*'  fire  damp  "  (an  explosive  mixture  of  carbureted  hydrogen  with 
atmospheric  air  in  the  proportion  of  6  to  10  volumes  per  cent)  and 
the  excessive  temperature,  real  hard  work,  constrained  attitude,  and 
careless  use  of  explosives  add  very  greatly  to  the  danger  of  miners. 

Much  can  be  done  to  prevent  accidents  by  the  introduction  of  safe 
hoisting  cages,  proper  engineering,  the  use  of  suitable  explosives, 
and  adequate  inspection  laws,  while  Davy's  safety  lamps,  incan- 
descent electric  lights,  and  copious  ventilation  will  serve  to  prevent 
explosions  of  fire  damp  and  aid  in  the  purification  of  the  air. 

RAILWAY  SERVICE. 

Employees  of  the  railway  service,  owing  to  a  life  full  of  hardships, 
exposures,  and  responsibilities,  together  with  irregular  habits,  suffer 
not  only  from  accidents,  but  also  experience  more  or  less  sickness, 
especially  from  rheumatic  affections,  diseases  of  the  digestive  and 
respiratory  organs,  and  injuries  and  disturbances  of  the  nervous  sys- 
tem. Forty-eight  per  cent  of  the  German  railway  employees  in  1885 
were  taken  sick,  as  follows:  Rheumatism,  8.18  per  cent;  digestive 
diseases,  11.12  per  cent;  respiratory  diseases,  8.53  per  cent;  nervous 
diseases,  2.73  per  cent.  The  train  hands  suffered  most,  and  the  office 
employees,  of  course,  the  least.  The  percentage  of  the  different  classes 
of  sick  employees  was  as  follows: 

Per  cent  of  German  raihcay  employees  taken  sick,  1885  and  1886,  by  occupations. 


Occupation. 


Train  arrangers 

Train  hands,  engineers,  conductors,  brakemen,  etc. 

Gate  lieepers,  etc 

Switch  tenders 

Track  watchmen 

Station  em  phjyees 

Office  employees 


1885.     1886. 


Hedinger  °  has  called  attention  to  the  fact  that  only  8  per  cent  of 
the  German  locomotive  engineers  have  normal  hearing,  while  67  per 
cent  of  the  engineers  and  30  per  cent  of  the  firemen  have  very  defect- 
ive hearing;  14.5  per  cent  of  the  track  walkers  also  had  defective 
hearing.  The  percentage  in  all  increased  with  the  length  of  the  serv- 
ice. The  most  common  affections  were  catarrh  of  the  internal  and 
middle  ear,  which  were  probably  due  to  abrupt  changes  in  tempera- 
ture. 

RAILWAY  ACCIDENTS. 

The  reports  ^  of  the  Interstate  Commerce  Commission  indicate  a 
constant  increase  in  the  number  of  injuries  from  railway  accidents. 
The  number  of  employees  killed  by  accidents  arising  from  the  move- 

oZeitschft.  des  Vereins.  d.  Eisenbahnverwaltungen,  27,  p.  25. 
*Text  of  the  Nineteentti  Annual  Report  on  the  Statistics  of  Railways  in  the 
United  States  for  the  year  ending  June  30,  1906. 


72 


KEPOBTS  OF   THE  PRESIDENT  S  HOMES  COMMISSION. 


ment  of  trains,  locomotives,  or  cars,  as  distinct  from  those  of  other 
causes,  in  1906,  was  3,709,  of  whom  2,310  were  trainmen,  and  42,962 
injured,  of  whom  34,989  were  trainmen.  The  number  of  fatalities  to 
trainmen  in  this  class  of  accidents  is  nearly  equally  distributed  among 
collisions,  falling  from  trains,  locomotives,  or  cars,  and  being  struck 
by  trains,  locomotives,  or  cars.  When  all  classes  of  employees  are 
taken  into  account  the  last-named  cause  is  responsible  for  the  greatest 
number  of  fatalities. 

"  Of  the  fatalities  to  passengers,  collisions  account  for  more  than 
any  other  single  cause,  although  the  number  due  to  jumping  on  or 
off  trains,  locomotives,  or  cars  is  nearly  as  great.  In  the  matter  of 
injuries,  however,  collisions  are  far  ahead,  being  responsible  for  more 
than  35  per  cent  of  the  total  injuries  to  passengers.  Taking  both 
passengers  and  employees  into  account,  it  is  seen  that  collisions  are 
responsible  for  a  much  higher  number  of  deaths  and  injuries  than  any 
other  one  class  of  accidents."  ^ 


Railway  accidents  for  the  years  1888  to  1906. 

[From  the  Nineteenth  Annual  Report  of  the  Interstate  Commerce  Commission  on  the 
Statistics  of  Railways  in  the  United  States,  p.  109.] 


Year  ending  June 

Employees. 

Passengers. 

Other  persons. 

Total. 

30- 

Killed. 

Injured. 

Killed. 

Injured. 

Killed. 

Injured, 

Killed. 

Injured. 

1888 

2,070 
1,972 
2,451 
2,660 
2,554 
2, 727 
1,823 
1,811 
1,861 
1,693 
1,958 
2,210 
2,550 
2,675 
2,969 
3,606 
3,632 
3,361 
3,929 

20,148 
20,028 
22,396 
26,140 
28,267 
31,729 
23,422 
25,696 
29,696 
27, 667 
81,761 
34,923 
39,643 
41, 142 
60,524 
60,481 
67,067 
66,833 
76,701 

315 
310 
286 
293 
376 
299 
824 
170 
181 
222 
221 
239 
249 
282 
345 
355 
441 
537 
359 

2,138 
2,146 
2,425 
2,972 
3,227 
3,229 
3,034 
2,375 
2,873 
2,795 
2,945 
3,442 
4,128 
4,988 
6,683 
8,231 
9,111 
10,457 
10,764 

2,897 
3,541 
3,598 
4,076 
4,217 
4,320 
4,300 
4,155 
4,406 
4,522 
4,680 
4,674 
5,066 
5,498 
6,274 
6,879 
5,973 
5,805 
6,330 

8,602 
4,135 
4,206 
4,769 
6,158 
5,435 
6,433 
6,677 
6,845 
6,269 
6,176 
6,255 
6,549 
7,209 
7,455 
7,841 
7,977 
8,718 
10,241 

5,282 
6,823 
6,335 
7,029 
7,147 
7,346 
6,447 
6,136 
6,448 
6,437 
6,859 
7,123 
7,865 
8,466 
8,588 
9,840 

10,046 
9,703 

10,618 

25,888 

1889                     

26,309 

1890 

29,027 

1891 

33, 881 

1892 

36, 652 

1893 

40,393 

1894 

31,889 

1895 

83,748 

1896 

88,687 

1897 

86,731 

1898 

40,882 

1899 

44,620 

1900          

60,320 

1901 

63,339 

1902 

64,662 

1903 

76,653 

1904 

84, 155 

1905 

86,008 

1906 

97,706 

In  1899  the  English  Government  appointed  a  commission  composed 
of  members  of  the  House  of  LfOrds  and  Commons,  representatives  of 
the  railway  companies,  railway  employees,  experts,  and  government 
officials,  with  a  view  of  determining  whether  the  accidents  to  railway 
employees  were  so  numerous  as  to  constitute  it  a  dangerous  trade. 

The  following  table  indicates  that  the  employment  of  shunters 
(switchmen)  is  far  more  dangerous  than  any  other  occupation  save 
seamen,  and  that  the  average  work  on  railways  is  almost  as  dangerous 
as  mining,  and  also  illustrates  the  relative  frequency  of  accidents  in 
other  occupations.^ 

« Nineteenth  Annual  Report  of  the  Interstate  Commerce  Commission  on  the 
Statistics  of  Railways  in  the  United  States,  p.  112. 
*  Dangerous  Trades,  Oliver,  pp.  199,  200. 


EEPORTS   OF   THE  PRESIDENT  S  HOMES  COMMISSION. 


73 


Number  of  employees  killed  and  injured  from  all  causes  per  1,000  employed 

in  various  occupations. 


Industry. 


Killed. 


Injured. 


Railway  servants  in   general,  excluding  contractors'   men,  cleiks,  and 

mechanics 

Goods  guards  and  brakemen 

Permanent- way  men  or  plate  layers 

Shunters 


Men  porters  (railway) 

Seamen  (merchant  service) 

Coal  miners: 

Underground 

Surface , 

Metalliferous  mines: 

Underground 

Surface 

Factories: 
Textile- 
Males 

Females , 

Nontextile — 

Males 

Females 

Extraction  of  metals  (males) . 

Shipbuilding  (males) 

Dock  laborers 


1.24 

2.92 

1.9 

6.08 

1.16 

5.2 

1.37 
.92 

1.34 
.43 


.1 


(«) 


31.0 
61.0 
16.0 
78.0 
63.0 


.2 


1.1 

.5 

1.4 


6.2 
2.7 

13.8 
2.0 
16.4 
39.3 
67.0 


a  Unknown. 


ACCIDENTS   AND   INJURIES. 


The  total  number  of  deaths  reported  during  the  census  year  of 
1900  was  57,513,  of  which  43,414  were  males  and  14,099  were  females, 
and  the  proportion  of  deaths  from  these  causes  in  1,000  deaths  from 
all  known  causes  was  57.6.  In  1890  the  corresponding  proportion 
was  53.7.  In  the  registration  area  the  rate  was  96  per  100,000  of 
population.  In  1890  the  death  rate  was  91.9.  The  rate  in  the  cities 
was  somewhat  higher  than  in  rural  districts,  and  the  rate  for  males 
was  about  three  times  as  high  (125.4)  as  it  was  among  females  (42.2). 
This  is  simply  due  to  the  more  sheltered  position  of  females  and 
because  males  alone  are  generally  engaged  in  the  more  dangerous 
operations. 

The  following  table  shows  for  the  registration  area  and  its  sub- 
divisions the — 

Death  rate  from  accidents  and  injuries  during   the  census  year  in  each  of 
three  age  groups  per  100,000  of  population. 


Registration  area. 

Under  15. 

15  to  44. 

45  and  over. 

Total 

67.0 

89.8 

150.5 

Males                                               

85.4 
48.6 

148.7 
31.1 

223  8 

78.0 

Cities                                            .  .           

70.2 
89.5 
50.9 
63.7 
80.6 
46.7 
08. 2 
86.1 
60.3 
57.2 
72.7 
41.8 

94.3 

156.6 
33.3 
73.4 

122.3 
24.9 
73.1 

122.  4 
25.9 
73.9 

122.1 
23.1 

163  8 

Males 

250,7 

Females 

80.1 

States                                                          

131  2 

Males 

187.8 

Females 

75.8 

Cities .      .      .                                      

139.7 

Males 

206.7 

Females 

77.9 

Rural 

122.6 

Males 

169.5 

Females 

73.6 

74  REPORTS   OF   THE  PRESIDENT'S   HOMES  COMMISSION. 

From  this  table  we  learn  that  the  highest  death  rate  from  acci- 
dents occurred  in  persons  45  years  and  over,  and  the  lowest  in  chil- 
dren under  the  age  of  15,  which  indicates  that  employment  in  fac- 
tories, mines,  and  workshops  influences  to  a  great  extent  the  number 
of  accidents  and  injuries.  The  rates  for  females  are  the  lowest  in 
all  three  age  groups,  for  reasons  already  assigned.  Woman  occupies 
a  more  favorable  position  even  in  childhood,  on  account  of  the  more 
reckless  disposition  of  boys,  whose  rates  are  probably  increased  by 
deaths  from  drowning,  falls,  burns,  gunshot  wounds,  railroad  acci- 
dents, etc. 

An  attempt  to  determine  the  number  of  persons  injured  to  1,000 
employed  in  the  factories  was  made  in  the  State  of  New  York  during 
1899.  The  data  are  based  upon  three  months'  observations  in  a 
selected  list  of  factories,  and  are  not  regarded  by  the  commissioner  of 
labor  and  chief  factory  inspector  of  the  State  as  absolutely  accurate. 

Number  of  persons  injured  to  1,000  employed. 


Industry. 


Number. 


Clothing,  millinery,  laundry,  etc.. 

Leather,  rubber,  pearl,  etc 

Textiles 

Printing  and  allied  trades 

Food,  tobacco,  and  liquors 

Stone  and  clay  products 

Wood 

Building  industry 

Metals,  machinery,  and  apparatus. 

Public  utilities 

Pulp,  paper,  and  cardboard 

Chemicals,  oils,  and  explosives — 


1.35 

3.21 

8.91 

9.19 

13.51 

15.18 

18.42 

26.20 

26. 57 

37.28 

41.46 

44.06 


Chapter  XL 
EMPLOYMENT  OF  WOMEN  AND  CHILDREN. 

In  the  face  of  the  many  adverse  circumstances  under  which  labor 
is  often  performed,  it  is  but  natural  that  the  immature  employees  and 
females  should  suffer  most.  The  former  not  infrequently  inherit  a 
weak  constitution  or  acquire  it  by  insanitary  homes  and  deficient  food, 
and  quite  a  number  are  obliged  to  enter  upon  active  work  long  before 
their  bodies  are  sufficiently  developed.  Quite  apart  from  the  fact  that 
child  labor  is  a  menace  to  education,  morals,  and  good  citizenship,  the 
effects  of  premature  and   involuntary  labor  upon  the  health   and 

Ehysical  welfare  of  the  child  are  extremely  detrimental.  Quetelet,  in 
is  Physique  Soci^le,  as  early  as  1869  demonstrated  that  the  muscles 
of  the  average  child  attain  only  at  the  age  of  13  or  14  a  certain  amount 
of  strength  and  capacity  for  work.  Up  to  this  time  the  muscular 
fibers  contain  a  larger  percentage  of  water,  and  in  consequence  are  very 
tender  and  immature.  Demetjeff,  cited  by  lliibner,"  determined  the 
lifting  poAver  of  the  arms  and  trunk  at  different  ages  of  the  working 
classes  to  be  as  follows: 

•Lelirbueh  d.  Hygiene,  Leipzig  uud  Wicu,  lUOG,  p.  709. 


REPORTS   OF   THE  PRESIDENT  S  HOMES  COMMISSION".  75 

Lifting  power  of  the  arms  and  trunk  of  the  working  classes  at  different  ages. 


Affe. 


Kilo- 
grams. 


14  years 

16  years 

18  years 

20  to  29  years 


82 
101 
128 
140 


Age. 


30  to  35  years 
35  to  40  years 
40  to  50  vears 
50  to  60  years 


KHo- 
grams. 


150 
160 
148 
184 


These  figures  clearly  indicate  that  the  average  boy  at  the  age  of  14 
possesses  about  one-half  the  muscular  strength  of  an  average  adult 
between  35  and  40  years  of  age. 

As  a  consequence  of  imperfect  muscular  development,  it  is  not 
surprising  that  a  large  percentage  of  young  persons  engaged  in  work- 
shops, factories,  or  even  at  the  writing  desk  or  merchant's  counter, 
develop  lateral  curvature  of  the  spine  and  other  muscular  deformities, 
not  to  mention  general  weakness  and  predisposition  to  rickets,  tuber- 
culosis, and  other  pulmonary  diseases.  All  of  the  bad  effects  are  nat- 
urally intensified  by  insanitary  environment,  especially  when  the 
occupations  are  attended  by  the  inhalation  of  dust,  injurious  gases, 
and  impure  air.  The  report  of  the  commission  on  child  labor, 
1833-34,  appointed  by  the  English  Parliament,  contains  many  inter- 
esting facts ;  but  in  spite  of  legislative  efforts  Dr.  Charles  W.  Roberts  » 
has  occasion  to  refer  to  the  prevalence  of  "  flat  feet,"  "  knock-knee," 
and  the  premature  aged  condition  of  youthful  employees. 

Doctor  Roberts  says: 

In  general  conformation  of  body  the  factory  children  do  not  compare  favor- 
ably with  the  agricultural.  In  the  manufacturing  towns  the  children  are 
short  of  stature,  have  thick  limbs,  and  large  feet  and  hands,  and  are  muscular 
and  in  tolerable  condition  as  to  fat.  They  produce  the  impression  on  the  mind 
of  having  bodies  too  old  for  their  heads  (and  ages).  "Flat  foot,"  with  a 
general  disposition  to  "  knockknee,"  is  very  common  among  the  factory  children, 
while  both  are  rare  among  the  agricultural,  among  whom  there  is  a  disposi- 
tion to  the  opposite  state,  of  bowleg. 

Doctor  Roberts  ^  examined  19,840  English  boys  and  men.  Of  these, 
5,915  belonged  to  the  nonlaboring  classes — school  boys,  naval  and 
military  cadets,  medical  and  university  students;  13,931  belonged  to 
the  artisan  class.  The  difference  in  height,  weight,  and  chest  meas- 
urement from  13  to  16  years  of  age  was  as  follows : 

Difference  in  height,  weight,  and  chest  measurement  of  19,8Ji6  English   boys 
and  men  at  specified  ages. 

AVERAGE  HEIGHT. 


Class. 

At  13 
years. 

At  14 
years. 

At  15 
years. 

At  16 
years. 

Inches. 
58.79 
55.93 

Inches. 
61.11 
67.76 

Inches. 
63.47 

60.58 

Inches 
66.40 

Artisan 

62  93 

2.66 

3.35 

2. 89           '■A  47 

o  London  Lancet,  1875,  p.  274. 

*  Cited  by  John  Spargo,  Bitter  Cry  of  the  Children,  1906,  p.  96. 


76 


REPORTS  OF  THE  PRESIDENT  S  HOMES  COMMISSION. 


Difference  in  height,  weight,  and  chest  measurement  of  J 9,846  English  hoys 
and  men  at  specified  ages — Continued. 

_       AVERAGE  WEIGHT. 


Class. 

At  13 
years. 

At  14 
years. 

At  15 
years. 

At  16 
years. 

Nonlabcring 

Pounds. 
88.60 
78.27 

Pounds. 
99.21 
84.61 

Pounds. 
110.42 
96.79 

Pounds. 
128.34 

Artisan .             

108.07 

Difference 

10.38 

14.60 

13.63 

19.64 

AVERAGE  CHEST  GIRTH. 

Nonlaboring 

Inches. 
28.41 
25.24 

Inches. 
26.28 
26.28 

Inches. 
30.72 
27.61 

Inches. 
33  08 

Artisan - 

28  97 

Difference 

3.17 

3.37 

8.21 

4  11 

Congress,  on  February  19,  1907,  authorized  a  federal  investigation 
of  the  subject  of  child  labor  under  the  direction  of  the  United  States 
Bureau  of  Labor,  and  the  results  of  such  investigation  may  more 
clearly  define  the  need  for  federal  legislation  or  indicate  other  means 
adapted  to  regulate  the  evil. 

During  the  census  year  of  1900  there  were  1,752,187  children  under 
16  years  of  age  employed  in  gainful  occupations ;  of  these  over  80,000 
were  employed  in  the  textile  industry;  7,116  in  the  glass  industry; 
about  25,000  in  mines  and  quarries;  12,000  in  the  manufacture  of 
tobacco  and  cigars ;  over  10,000  in  wood  industries ;  over  7,000,  mostly 
girls,  were  employed  in  laundries;  2,000  in  bakeries;  138,000  as  wait- 
ers and  servants ;  42,000  boys  as  messengers ;  and  20,000  boys  and  girls 
in  stores.  Mr.  John  Spargo,  in  "  The  Bitter  Cry  of  the  Children,"  on 
page  211,  gives  the  result  of  his  investigation  covering  213  cases  of 
child  labor  with  a  view  of  determining  the  cause.  He  found  that  52 
children  were  obliged  to  work  because  their  father  earned  less  than 
$10  a  week ;  in  13  instances  the  father  was  out  of  employment ;  in  19 
the  father  was  sick;  in  12  the  father  had  died;  in  4  the  father  had 
deserted  the  family ;  in  4  other  instances  he  was  intemperate,  and  in 
1  case  the  father  was  in  prison.  He  concludes  that  in  these  105 
instances  the  primary  cause  was  poverty. 

Of  108  other  children,  the  causes  are  given  as  follows :  School  dif- 
ficulties, 30 ;  "  because  friends  went  to  work,"  18 ;  "  to  get  better 
clothes,"  11;  "  to  enable  parents  to  save,"  17;  sickness  while  in  school, 
6 ;  father's  laziness,  2 ;  not  determined,  25. 

Child  labor  differs  in  degree  as  well  as  in  kind.  The  ordinary  mes- 
senger or  newsboy  may  not  sacrifice  his  health,  but  his  morals  and 
his  education  must  inevitably  suffer.  And  so  we  see  different  grada- 
tions until  some  of  the  most  injurious  forms  of  child  labor  are  en- 
countered. 

Dr.  Annie  S.  Daniel,  in  speaking  of  her  personal  observations  in 
New  York,  tells  us  that  a  child  3  years  old  can  straighten  out  the 
leaves  of  tobacco  and  can  stick  together  the  materials  which  form 
the  stems  of  artificial  flowers;  at  4  he  can  put  the  cover  on  paper 

•Cbaiitles.  April  1,  1905. 


REPORTS    OF    THE  PRESIDENT'S   HOMES   COMMISSION.  77 

boxes;  between  4  and  6  he  can  sew  on  buttons  and  pull  basting 
threads.  A  girl  from  8  to  12  can  finish  trousers  as  well  as  her 
mother.  After  she  is  12,  if  of  good  size,  she  can  earn  more  money  in 
a  factory,  because  she  will  be  accepted  if  her  size  justifies  the  evasion 
of  the  law.  The  boys  practically  perform  the  same  labor  as  the  girls, 
except  that  they  leave  home  earlier  and  engage  in  street  work  as 
peddlers,  newsboys,  or  bootblacks.  Doctor  Daniel  has  actually  seen 
two  children  under  3  years  of  age  working  in  the  tenements  of  New 
York — one,  a  boy  2J  years  of  age,  assisting  the  mother,  and  four  other 
children  under  the  age  of  12,  in  making  artificial  flowers.  "  These 
children  earn  from  50  cents  to  $1.50  a  week,  obviously  at  the  expense 
of  health  and  education — rights  which  neither  the  parents  nor  the 
community  nor  the  State  have  a  right  to  withhold." 

A  feeling  seems  to  exist  in  Washington  that  there  is  no  special  need 
for  the  enactment  of  a  law  to  prevent  or  regulate  child  labor,  but  the 
same  class  of  people  told  us  years  ago,  that  we  had  no  slums,  and 
hence  there  was  no  occasion  for  the  betterment  of  the  housing  con- 
ditions, when,  as  a  matter  of  fact,  investigations  have  shown  con- 
clusively that  in  many  respects  we  are  as  badly,  if  not  worse,  off  than 
the  cities  of  New  York  and.  Chicago.  Those  who  are  familiar  with 
the  subject  know  that  there  is  a  local  situation  which  demands  legis- 
lation. But  whether  the  number  is  large  or  small  it  matters  little, 
and  it  is  clearly  the  duty  of  every  community  to  resort  to  preventive 
measures  against  this  hydra-headed  evil. 

It  has  been  asked.  What  is  the  use  of  enacting  child-labor  laws 
when  such  atrocious  instances  are  possible  in  the  city  of  New  York, 
where  child-labor  law  exists?  And  it  must  be  granted  that  just  such 
evils  will  be  witnessed  in  New  York  or  any  other  American  city  so 
long  as  public  opinion  and  the  conscience  of  the  American  people  is 
not  sufficiently  aroused  to  demand  the  enforcement  of  the  Jaw. 

It  has  been  estimated  that  there  are  in  this  city  between  1,500  and 
2,000  children  under  the  age  of  15  engaged  in  wage-earning  occupations. 
And  we  feel  that  the  enactment  of  a  suitable  law  would  guard  these 
children  and  afford  them  a  better  opportunity  of  becoming  useful 
citizens,  and  the  consumers  would  at  least  have  the  satisfaction  of 
knowing  that  they  are  not  stained  with  the  sweat  and  blood  of  help- 
less children. 

How  many  more  of  the  6,000  children  between  the  ages  of  8  and  12 
who  are  not  now  at  school  are  engaged  in  wage-earning  occupations 
we  do  not  know.  But  whether  they  are  at  work  because  of  the  neces- 
sities of  their  parents  or  because  of  their  own  disinclination  to  study, 
the  law  should  intervene  and  establish  an  effective  remedy. 

It  has  been  urged,  and  no  doubt  in  many  instances  quite  correctly, 
that  child  labor  is  encouraged  by  the  greed  of  the  employers,  but  the 
writer  is  in  a  position  to  know  that  the  business  men  of  this  city  would 
hail  with  delight  the  enactment  of  a  child-labor  law.  As  it  is  now,  it 
is  not  always  an  easy  matter  to  refuse  to  lend  a  halping  hand  in  appar- 
ently deserving  and  pathetic  cases. 

It  is,  indeed,  deplorable  that  so  little  has  been  accomplished  in  the 
way  of  educating  the  public  to  a  sound  and  full  appreciation  of  the 
evil  consequences  of  child  labor,  and  it  is  especially  humiliating  to 
know  that  the  District  of  Columbia,  the  seat  of  the  National  Govern- 
ment, is  the  only  community  with  the  exception  of  Georgia,  Idaho, 


78  REPOETS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

Nevada,  and  the  Indian  Territory,  which  is  at  present  without  legisla- 
tion of  some  kind  on  the  subject  of  child  labor. 

Women,  on  account  of  their  imperfectly  developed  muscular  system 
and  more  delicate  physique,  are  unfitted  for  hard  work;  nor  should 
they  be  obliged  to  work  steadily  in  a  sedentary  position,  especially  at 
the  sewing  machine  or  other  occupations  involving  the  use  of  the  lower 
extremities.  Special  protection  should  be  extended  to  them  during  the 
child-bearing  period.  It  is  a  matter  of  constant  observation  that 
women  who  have  to  deny  themselves  proper  rest  and  care  during  the 
six  weeks  before  and  after  confinement  are  very  liable  to  suffer  from 
hemorrhages  and  chronic  uterine  diseases,  while  miscarriages  and 
premature  births  are  not  infrequent  results  of  overwork.  Recent 
statistics  collected  by  Doctor  Neisser  (1907)  indicate  that  such  acci- 
dents are  quite  frequent  among  farmers'  wives  and  women  employed 
in  the  jewelry  industry,  where  the  motor  power  is  supplied  by  the 
feet. 

INFANT  MORTALITY  IN  RELATION  TO  THE  OCCUPATION  OF  WOMEN. 

Attention  has  been  directed  on  another  page  to  the  high  rate  of  in- 
fant mortality  in  certain  mill  toAvns  of  Massachusetts.  This  subject 
has  received  careful  attention,  especially  in  England.  The  investiga- 
tions made  by  Sir  John  Simon  and  his  colleagues  into  the  sanitary 
condition  of  England  between  1859  and  1865  showed  "  that  in  propor- 
tion as  adult  women  were  taking  part  in  factory  labor  or  in  agriculture 
the  mortality  of  their  infants  rapidly  increased."  Among  other  causes, 
Simon  attributes  the  excessive  mortality  of  infants  under  1  year, 
which  in  some  registration  districts  was  from  two  and  a  quarter  to 
nearly  three  times  as  high  as  in  standard  districts,  "  to  occupational 
differences  among  inhabitants,  there  being  certain  large  towns  where 
women  are  greatly  engaged  in  branches  of  industr^^  away  from  home, 
where,  consequently,  these  houses  are  ill  kept,  where  the  children 
are  little  looked  after,  and  where  infants  who  should  be  at  the  breast 
are  improperly  fed  or  starved,  or  have  their  cries  of  hunger  and  dis- 
tress quieted  by  those  various  fatal  opiates  which  are  in  such  request 
at  the  centers  of  our  manufacturing  industry."  ^ 

Fifty  years  have  elapsed  since  Simon  declared  "  infants  perish 
under  the  neglect  and  mismanagement  which  their  mothers'  occupa- 
tion implies."  The  subject  has  since  been  studied  by  the  medical 
officers  of  the  home  office,  the  local  government  board,  and  1,800  local 
health  boards  in  England.  Doctor  Newman  has  carefully  surveyed 
the  facts  concerning  the  number  of  females  employed  in  gainful  occu- 
pations, the  percentage  of  married  women,  the  infant  mortality  rate  in 
towns  having  a  low  percentage  of  women  so  employed,  as  compared 
with  textile  towns,  where  the  percentage  of  female  employees  is  high. 
He  has  given  careful  consideration  to  the  character  and  condition  of 
the  work,  the  length  of  working  hours,  employment  before  and  after 
childbirth,  and  the  sanitation  of  workshops.  He  dwells  very  justly 
upon  the  evil  effects  of  the  added  strains  of  factory  life,  such  as 
piecework,  hard  physical  labor,  injurious  trade  processes,  fatigue,  etc. 

Doctor  Newman  tells  how  in  some  trades,  like  brickmaking,  tin- 
plate  works,  iron  hollow  ware,  certain  hardware  trades,  jam  and  sauce 

«  Papers  Relating  to  the  Sanitary  State  of  tlie  People  of  England,  1858. 


REPORTS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  79 

factories,  and  mat  work,  women  are  not  infrequently  employed  in  car- 
rying or  lifting  weights  altogether  beyond  their  physical  endurance. 
He  emphasizes  the  various  dangers  to  which  the  female  employees  are 
exposed,  and  sunmiarizes  the  direct  injuries  as  follows:  (a)  Accidents 
from  machinery,  materials,  and  other  external  agents;  (h)  injury  or 
poisoning  from  toxic  substances,  or  injury  from  excessive  dust,  fumes, 
vapor,  or  extremes  of  temperature  (he  refers  also  to  anthrax  infec- 
tions in  horsehair  factories,  tetanus  in  jute  works,  lung  diseases  in 
dusty  trades,  and  abortion  in  lead  works)  ;  (c)  injury  through  fatigue 
and  strain,  long  hours,  insufficient  periods  of  rest  for  food;  (d)  injury 
derived  from  defective  sanitary  conditions,  such  as  bad  ventilation, 
dampness,  insufficiency  or  unsuitability  of  sanitary  conveniences ;  and 
(e)  too  short  a  period  of  rest  at  the  time  of  childbirth.'^ 

He  declares  that  the  official  reports  of  factory  inspectors  and  of 
medical  officers  of  health  reveal  ample  evidences  of  these  injuries,  and 
adds:  "Where  the  conditions  resulting  in  these  evils,  coupled  with 
the  absence  of  the  mother  from  home,  are  present,  the  infant  mortal- 
ity is  high;  where  they  are  not  present  it  is  usually  low."  He  de- 
scribes the  general  effects  of  the  factory  system  at  Dundee,  where 
24,879  women  and  girls  are  employed  in  the  jute  and  hemp  factories, 
and  another  3,000  women  are  employed  in  other  textile  works.  One 
quarter  of  the  women,  or  about  6,000,  are  married,  and  about  16  per 
cent  of  all  the  girls  in  Dundee  between  the  ages  of  10  and  14  are  em- 
ployed in  these  trades. 

The  infant  mortality  rate  for  Dundee  "  is  exceptionally  high,  and 
for  the  decennial  1893-1902  was  176  per  1,000  births."  In  1904  there 
were  788  infant  deaths,  129  of  which  occurred  within  the  first  Aveek, 
and  all  but  four  of  these  were  medically  certified  as  due  to  "  prema- 
turity and  immaturity."  Nearly  one-half  of  the  total  number  oc- 
curred in  the  first  three  months  of  life.  Inquiry  was  made  into  the 
social  conditions  of  the  home  life  of  364  of  these  infant  deaths.  "  The 
occupations,  or  former  occupations,  of  the  mothers  were  as  follows: 
Eighty-four  weavers,  warpers,  or  winders;  105  spinners,  piecers,  or 
shifters;  88  preparers;  12  sack  machinists  or  sack  sewers;  27  mis- 
cellaneous; 20  unoccupied,  and  25  concerning  which  there  was  no 
return  obtainable.  Of  the  cases  inquired  into  13.2  per  cent  of  these 
mothers  worked  at  the  factory  to  within  a  week  of  childbirth.  Fif- 
teen women  worked  to  within  a  few  hours  of  childbirth." 

Doctor  Newman's  final  conclusion  on  the  subject  of  infant  mortality 
in  relation  to  the  occupation  of  women  is  as  follows :  ^ 

No  doubt  the  factory  plays  a  part,  but  the  home  plays  a  vastly  greater  part, 
in  the  causation  of  infant  mortality  in  the  towns  where  women  are  employed  at 
the  mills.  There  are  two  influences  at  work — first,  the  direct  injury  to  the 
physique  and  character  of  the  individual  caused  by  much  of  the  factory  em- 
ployment of  women,  and,  secondly,  the  indirect  and  reflex  injury  to  the  home 
and  social  life  of  the  worker.  We  can  not  afford  to  forget  either  of  these  points 
in  attempting  to  estimate  the  operations  of  the  factory  in  infant  mortality.  It 
is  because  they  have  not  been  sufliciently  correlated  together  that  fallacy  has 
arisen  in  the  past.  But  even  yet  we  have  not  flnished.  "  Infantile  mortality 
in  Lancashire,"  writes  an  experienced  medical  officer. of  health  for  a  town  in 
that  county  with  an  infant  mortality  in  1904  of  222,  "  is,  I  am  sorry  to  say,  as 
much  a  financial  as  a  hygienic  question."  Why  do  married  women  work  in  the 
mills?  is  the  question  this  medical  officer  has  reached.     His  answer  is  that  "a 


*  Infant  Mortality,  George  Newman,  M.  D.,  New  York,  1907, 
>  Infant  Mortality,  Newman,  p.  137. 


80  REPOKTS   OF   THE  PRESIDENT'S   HOMES  COMMISSION. 

weaver's  wages  will  not  allow  of  the  wife's  remaining  at  home,  considering  the 
high  rents  and  rates,  and  so  both  go — which  is  the  rule — and  a  hand-to-mouth 
existence  results  even  for  themselves,  let  alone  the  little  ones,  who  are  left  in 
the  intervals  to  the  mercies  of  the  nurse,  who,  as  a  rule,  takes  in  the  babies  to 
eke  out  her  own  husband's  wages.  Much  good  may  be  done  by  hygienic  tuition, 
but  I  am  certain  that  the  root  of  the  whole  matter  with  us  is,  as  I  have  said, 
comparatively  low  wages  and  high  rents  and  rates. 

In  the  discussion  of  infant  mortality  it  would  be  unfair  not  to  em- 
phasize other  facts,  such  as  impure  and  dirty  milk  and  1-room  tene- 
ments. Of  54,047  infantile  deaths  which  were  investigated  both  in 
the  Old  and  the  New  World  as  to  the  character  of  feeding,  it  was 
found  that  86  per  cent  had  been  artificially  fed.  Neumann,"  in  inves- 
tigating 2,711  infantile  deaths  in  Berlin,  found  that  1,792  occurred  in 
1-room  apartments,  754  in  2-room  apartments,  122  in  3-room  apart- 
ments, and  43  in  apartments  of  4  rooms  and  over. 

It  is  hoped  that  Doctor  Newman's  study  of  the  subject  will  result 
everywhere  in  the  amelioration  of  existing  conditions,  for,  as  pointed 
out  by  the  author  and  Sir  John  Simon,  a  high  death  rate  of  infants 
suggests  racial  degeneracy  and  is  at  least  "  an  indication  of  the  exist- 
ence of  evil  conditions  in  the  homes  of  the  people — which  are,  after 
all,  the  vitals  of  the  nation." 

Doctor  Daniels,  in  speaking  of  the  female  labor  question  in  New 
York,  says : 

That  in  no  case  in  over  515  families  examined  by  her  was  any  woman  work- 
ing other  than  from  dire  necessity.  The  average  weekly  income  from  the 
man's  work  was  $3.81.  The  average  rent  was  $9  per  month.  The  average 
family  to  be  supported  was  4i  persons.  As  it  requires  more  than  two  weeks' 
wages  to  pay  one  month's  rent,  it  is  evident  that  the  women  and  children  must 
work  or  the  family  go  hungry.     (Charities,  April  1,  1905.) 

Those  interested  in  female  labor  as  carried  on  in  the  "  sweat  shops  " 
of  New  York  at  the  rate  of  $3  to  $4  a  week  should  not  fail  to  read 
''The  Long  Day:  The  True  Story  of  a  New  York  Working  Girl 
as  Told  by  Herself." 

Chap'iier  XII. 

SPECIAL    MEASURES     FOR    THE    PREVENTION    OF    TUBERCULOSIS 
AMONG  WAGE-EARNERS. 

There  is  abundant  statistical  evidence  to  show  that  industrial 
workers  pay  a  very  heavy  tribute  to  the  so-called  "  white  plague ; " 
nor  is  it  cause  of  wonder  when  the  many  unfavorable  factors  to  which 
they  are  subjected  are  considered,  such  as  crowded  and  insanitary 
workshops,  deficient  light,  overwork,  long  hours  in  a  bad  air,  damp- 
ness, exposure  to  extremes  of  heat  and  cold,  sudden  changes  in  tem- 
perature, and  the  inhalation  of  irritating  dust,  vapors,  etc.  All  of 
these  factors  are  calculated  to  lower  the  power  of  resistance  and 
favor  the  spread  of  disease,  especially  when  some  of  the  workmen 
themselves  are  already  afflicted  and  are  careless  in  the  disposition  of 
their  expectoration. 

On  the  other  hand,  it  would  be  unfair  not  to  consider  the  influence 
of  home  environment,  such  as  unclean  and  crowded  or  otherwise 
insanitary  dwellings,  insufficient  or  improper  food,  and  last,  but  not 

•  Deutsche  med.  Wochenschrift,  Leipzig,  1904,  p.  1723, 


KEPORTS   OF   THE  PKESIDENT's  HOMES  COMMISSIOK.  81 

least,  the  bad  effects  of  the  abuse  of  alcohol.  It  has  been  shown  that 
alcohol  not  only  affects  the  digestive  and  nervous  functions,  in  con- 
sequence of  which  the  general  nutrition  of  the  bod^  is  markedly 
reduced,  but  the  habit  of  visiting  and  remaining  m  saloons  for 
hours,  sometimes  till  midnight,  deprives  the  individual  of  proper  rest 
and  exposes  him  to  the  poisonous  fumes  of  tobacco,  coal  and  carbonic- 
acid  gases,  and  other  injurious  agents.  The  preventive  measures  are 
partly  the  duty  of  the  State,  which  should  regulate  the  air  space  and 
ventilation  of  the  workshops  and  dwellings  and  improve  the  working 
conditions  by  forced  ventilation  and  "wet  processes"  in  order  to 
diminish  dust  production  and  exposure  to  irritating  gases.  On  the 
other  hand,  it  is  clearly  the  duty  of  the  worlanen  themselves  and  the 
community  at  large  to  improve  social  and  housing  conditions.  In 
view  of  the  undue  prevalence  of  consumption  among  file  cutters, 
metal  grinders,  stone  cutters,  and  cotton,  flax,  and  tobacco  operatives, 
persons  predisposed  to  this  disease  should  be  cautioned  against 
engaging  in  such  occupations.  Simple  printed  instructions  should 
be  given  as  to  the  part  expectoration  plays  in  the  spread  of  consump- 
tion. Cuspidors  in  sufficient  number  and  properly  disinfected  should 
be  provided,  preferably  one  for  each  workman,  and  promiscuous 
expectoration  should  be  forbidden. 

Chapter  XIII. 

MEASURES  FOR  THE  PROTECTION  OF  WAGE-EARNERS. 

From  what  has  been  said  it  is  evident  that  the  laboring  classes  need 
special  protection  against  the  many  dangers  referred  to,  and  this 
should  emanate  from  the  State,  the  employers,  the  community,  and 
the  employees  themselves. 

One  of  the  important  predisposing  causes  to  disease  is  overwork  or 
fatigue,  because  the  accumulation  of  waste  products  in  the  blood, 
from  muscular  wear  and  tear,  together  with  the  expended  nervous 
energy,  combine  to  render  the  system  more  susceptible  to  disease. 
Excessive  work  is  inimical  to  health,  and  long  hours  and  hard  work 
are  calculated  to  diminish  the  general  power  of  resistance,  and  thus 
bring  about  physical  deterioration.  Hence  the  necessity  of  laws  regu- 
lating the  hours  of  labor  and  the  enforcement  of  a  day  of  rest  as 
contemplated  by  the  Sunday  laws. 

Professor  Roth's  conclusions  on  this  subject  are  as  follows :«  (1)  In 
order  to  prevent  a  state  of  chronic  fatigue  it  is  essential  that  the 
amount  of  work  be  regulated  by  the  capacity  of  the  individual; 
(2)  the  more  intensive  the  work  and  the  shorter  the  intervals  of  rest 
for  the  elimination  of  waste  products  the  earlier  we  may  expect  mani- 
festations of  fatigue,  and  the  working  hours  must  be  regulated  ac- 
cordingly;  (3)  other  industrial  dangers,  like  excessive  heat,  humidity, 
violent  concussions,  constrained  attitude,  overexercise  of  certain 
groups  of  muscle,  exposure  to  vitiated  air  and  toxic  agents  favor 
premature  fatigue,  and  should  be  controlled  by  rational  measures; 

«  Ermuedimg  dnrcli  Berufsarbeit  Intern.    Kongress  fuer  Hygiene  und  Demo- 
gaphie,  Berlin,  1907,  Band,  ii,  p.  620. 
S.  Doc.  644,  60-2 1 


82  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

(4)  insufficient  and  improper  food,  vicious  habits,  long  walks  to  place 
of  work,  and  abuse  of  alcoholic  drinks  lower  the  vital  powers  and 
produce  premature  fatigue;  (5)  monotonous  work  or  any  employ- 
ment involving  responsibility  and  intense  mental  application  are  con- 
ducive to  fatigue.  All  of  these  factors  should  be  considered  and 
controlled  by  suitable  preventive  measures,  so  as  to  avoid  the  chronic 
effects  of  fatigue,  which  are  generally  evinced  by  anaemia,  digestive 
derangements,  neurasthenia,  respiratory  and  cardiac  difficulties. 

No  child  should  be  permitted  to  work  in  factories  and  wage-earning 
occupations  under  the  age  of  14,  and  then  only  upon  presentation  of  a 
medical  certificate  that  it  is  free  from  physical  defects.  Such  children 
should  not  be  obliged  to  work  longer  than  six  hours,  with  a  two-hour 
interval  of  rest  after  the  first  three  hours,  so  that  they  may  be  able 
to  enjoy  their  noon  dinner.  Under  no  circumstances  should  they  be 
permitted  to  perform  night  work  or  engage  in  the  so-called  danger- 
ous occupations.  The  same  may  be  said  of  indi\dduals  between  the 
age  of  16  and  18  years,  who,  however,  may  be  permitted  to  work  eight 
hours  a  day,  with  proper  intervals  for  meals  and  rest. 

Women,  even  from  a  moral  standpoint,  should  not  be  permitted 
to  work  in  factories  or  shops  after  sundown.  The  laws  of  some  coun- 
tries prescribe  one  hour  for  nooning,  if  they  have  their  own  house- 
holds, and  their  exclusion  from  factories  six  weeks  before  and  after 
confinement,  while  in  other  countries  hard  labor  for  women  is  strictly 
forbidden. 

SANITATION   OF   WORKSHOPS   AND   QUARTERS   FOR   EMPLOYEES. 

The  protection  of  wage-earners  should  extend  to  the  work  and 
workshops,  and,  in  case  the  employees  are  housed  by  the  employer, 
also  to  the  living  and  sleeping  quarters. 

A  sanitary  workshop  demands  sufficient  air  space  for  each  inmate, 
a  suitable  temperature,  proper  ventilation  and  illumination,  general 
cleanliness,  and  suitable  opportunities  for  personal  cleanliness.  The 
necessity  for  abundant  ventilation  is  apparent  when  it  is  recalled  that 
men  at  work  eliminate  more  carbonic-acid  gas  than  individuals  at 
rest,  and  that  in  the  majority  of  occupations  the  air  is  further  vitiated 
by  the  presence  of  dust  and  gases. 

The  question  of  illumination  is  not  only  important  for  the  preven- 
tion of  defective  vision  and  accidents,  but  when  recourse  is  had  to  arti- 
ficial illumination  the  additional  vitiation  of  the  air  must  be  con- 
sidered. Such  matters,  which,  after  all,  are  largely  questions  of 
public  health,  should  not  be  left  to  the  individual  employer,  but 
the  principles  of  industrial  hygiene  which  ought  to  be  adopted  should 
be  embodied  in  suitable  laws  and  enforced  by  competent  inspectors. 
Among  the  most  dangerous  forms  of  workshops  is  one  class  whicli 
most  state  laws  entirely  ignore.  For  example,  under  the  law  of  tlie 
State  of  New  York  relating  to  manufacturing  in  tenement  houses,  33 
distinct  industries  may  be  carried  on  in  the  living  rooms  of  the 
workers,  because  they  involve  hand  work  or  simple  machinery.  There 
are  over  23,000  licensed  "  home  factories  "  in  the  city  of  New  York 
alone.  Dr.  Annie  S.  Daniels,  who  made  a  special  investigation  of 
manufacturing  in  tenements,  says  <»  "  that  every  garment  worn  by  a 

•  Charities,  April  1,  1905. 


/ 

REPORTS   OP   THE   PRESIDENT'S   HOMES   COMMISSION.  83 

woman  is  found  being  manufactured  in  tenement  rooms;  the  same  is 
true  of  clothing  worn  by  infants  and  young  children.  In  addition 
to  wearing  apparel  for  men,  women,  and  children,  including  adorn- 
ments of  woman's  dress,  the  flowers  and  feathers  for  her  hats,  the  hats 
themselves,  and  neckwear  of  every  description,  she  found  the  manu- 
facture of  paper  boxes,  cigars,  pocketbooks,  jewelry,  clocks,  watches, 
wigs,  fur  garments,  paper  bags,  etc.,  and  the  articles  frequently 
handled  and  stored  in  infected  rooms."  According  to  Doctor  Daniels, 
among  the  150  families  tabulated  by  her,  66  continued  at  work  during 
the  entire  course  of  the  contagious  disease  for  which  she  was  attending 
the  family,  and  the  question  naturally  arises.  How  many  germs  of 
tuberculosis,  measles,  scarlet  fever,  diphtheria,  and  other  infectious 
diseases  may  be  sewed  in  the  garments  made  in  the  tenement  "  sweat 
shops  ?  "  "And  last,  but  not  least,  the  greatest  danger  falls  upon  the 
workers — ^it  means  the  loss  of  health,  physically  and  morally,  the 
loss  of  home,  because  home  life  is  impossible  in  a  tenement  workroom." 
Apart  from  the  occupations  referred  to,  numerous  bakeries,  candy, 
ice-cream,  and  milk  shops ;  butcher  shops  and  sausage  factories ;  bot- 
tling establishments;  tailor,  cobbler,  and  other  repair  shops  are 
carried  on  in  basements  under  the  most  insanitary  surroundings  as 
regards  workrooms  and  sleeping  quarters. 

CUBIC   AIR   SPACE   AND   AMOUNT  OF   FRESH    AIR   PER   HOUR. 

Reference  has  been  made  to  the  baneful  effects  of  vitiated  air,  which 
are  of  course  intensified  when  the  occupation  is  attended  with  the  pro- 
duction of  dust  and  irritating  fumes  or  gases.  It  is  known  that  car- 
bonic acid  is  not  itself  a  toxic  agent,  but  an  excess  of  this  gas  in  the  air 
of  rooms  leads  to  a  deficiency  of  oxygen  and  also  to  defective  elimina- 
tion of  carbonic  acid  from  the  system,  which  can  not  be  excreted 
whenever  the  tension  of  carbonic  acid  in  the  air  exceeds  that  of  the 
carbonic  acid  in  the  blood.  In  order  that  the  respiratory  impurities 
may  not  exceed  certain  limits  (6  volumes  of  carbonic  acid  per  10,000), 
it  has  been  found  that  an  average  adult  requires  3,000  cubic  feet  of 
fresh  air  per  hour,  and  this  amount  should  be  supplied  without  dis- 
comfort to  the  occupants.  Experience  has  shown  that  the  air  of  a 
room  can  not  be  changed  oftener  than  three  times  in  one  hour  in 
winter  without  causing  a  disagreeable  draft;  hence  every  occupant 
should  have  a  cubic  air  space  of  1,000  feet.  This  is  the  ideal  standard, 
and  section  100  of  the  factory  laws  of  New  York  of  1901  (as  amended  by 
chapter  129,  acts  of  1906),  relating  to  certain  manufactures  in  tene- 
ments, provides  "  that  the  whole  number  of  persons  therein  shall  not 
exceed  one  to  each  1,000  cubic  feet  of  air  space."  Such  an  ideal 
standard,  however,  is  not  alwaj^s  attainable  in  workshops,  and  it  is 
believed  that  for  practical  purposes  an  air  space  of  from  400  to  500 
cubic  feet  per  capita  will  suffice. 

The  States  of  New  York,  Indiana,  Michigan,  New  Jersey,  Ohio, 
Pennsylvania,  and  Wisconsin  appear  to  be  the  only  States  which 
make  a  definite  provision  on  this  point,  and  they  require  an  air  space 
of  250  cubic  feet  for  each  employee  between  the  hours  of  6  a.  m.  and 
6  p.  m.,  and,  unless  by  written  consent  of  the  factory  inspector,  not 
less  than  400  cubic  feet  for  each  employee  between  the  hours  of  6  p.  m. 
and  6  a.  m.,  provided  such  room  is  lighted  by  electricity,  etc.  This  is 
a  step  in  the  right  direction,  but  it  would  be  extremely  desirable  to 


84  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

place  the  minimum  amount  of  cubic  air  space  at  400  feet  for  day 
work  and  500  feet  for  night  work,  unless  electricity  is  used,  in  which 
case  a  uniform  standard  of  400  feet  might  be  prescribed.  At  all 
events  the  question  of  sufficiency  ought  not  to  be  left  to  the  discretion 
of  the  factory  inspector.  Either  the  cubic  air  space  should  be  speci- 
fied or  the  carbonic  acid  limited  to  12  volumes  per  10,000. 

VENTILATION. 

Ventilation,  which  means  the  removal  and  dispersion  of  bad  air 
and  the  introduction  of  fresh  air,  is  accomplished  either  by  natural 
or  artificial  means.  Natural  ventilation  is  usually  sufficient  when  each 
occupant  has  1,000  feet  of  cubic  air  space,  the  walls  of  the  building 
are  porous  or  contain  numerous  crevices  near  the  doors  and  windows, 
the  difference  betwen  the  indoor  and  outdoor  temperature  is  consider- 
able, and  the  winds  strike  the  walls  directly  or  pass  with  great  veloc- 
ity over  chimney  flues  or  other  openings.  But  as  the  direction  and 
force  of  the  winds  and  the  other  factors  referred  to  can  not  be  con- 
trolled, other  means  should  be  provided  for  ventilation.  For  this 
purpose,  open  windows,  doors,  and  revolving  fans  answer  very  well  in 
summer.  The  objection  to  this  method  are  the  cold  drafts  in  winter. 
In  rooms  heated  with  direct  radiation  the  fresh  air  should  therefore 
be  admitted  above  the  heads  of  the  occupants,  either  by  fresh-air  reg- 
ister inlets  in  the  walls  or  by  the  insertion  of  louvered  or  swinging 
windows,  thus  an  upward  direction  being  given  to  the  air,  so  that  it 
rnay  impinge  on  the  ceiling,  mix  with  and  be  warmed  by  the  heated 
air  in  this  situation,  falling  gently  into  all  parts  of  the  room,  and  being 
gradually  removed  by  means  of  the  foul-air  outlets,  aided  by  exhaust 
fans.  Another  simple  plan  is  to  bore  slanting  holes  in  the  bottom 
rail  of  the  window  sash,  or  to  employ  a  Pullman  or  Bury  ventilator, 
or  to  insert  a  piece  of  board  4  inches  wide  across  the  window  sill. 
The  separation  of  the  sashes  thus  caused  will  provide  for  indirect 
fresh-air  inlets. 

Artificial  ventilation,  which  may  be  secured  by  providing  (1)  suit- 
able inlets  and  outlets;  (2)  by  extraction  by  heat,  or  the  creation  of 
a  decided  difference  between  the  inner  and  outer  temperature;  and, 
(3)  by  propulsion  and  aspiration.  Space  will  not  permit  to  enter 
into  details  except  to  say  that  besides  the  contrivances  already  men- 
tioned, any  of  the  ordinary  registers  in  which  the  air  passes  through 
the  walls  by  means  of  a  perforated  iron  plate  and  is  then  directed 
upward  by  a  valved  plate  with  side  checks  will  prove  of  service. 
McKinnel's  ventilator  consists  of  two  cylinders,  one  inside  the  other 
and  of  different  lengths,  the  longer  tube,  projecting  above  and  below, 
serves  to  conduct  the  impure  air,  while  the  outer  cylinder,  having  a 
larger  sectional  area,  serves  as  an  inlet.  The  outlet  is  protected  on  the 
top  with  a  cowl,  and  both  tubes  can  be  regulated  by  valves.  They 
are  especially  useful  in  the  ventilation  of  one-story  buildings  or  the 
upper  story  of  any  building.  If  gas  is  used  as  an  illuminant,  the 
burners  may  be  placed  immediately  under  the  extracting  tube.  As 
the  warm  air  escapes  through  the  inner  tube  a  corresponding  volume 
is  admitted  through  the  interspace  between  the  two  cylinders. 

The  Ridge  ventilators  consist  of  openings  through  the  ceiling  and 
roof  with  louvered  sides  and  ends,  protected  with  a  small  roof,  the 
opening  of  the  air  shaft  in  the  ceiling  usually  being  provided  with 


REPORTS   OF   THE  PRESIDENT  S  HOMES   COMMISSION.  85 

suitable  registers.  The  fresh  air  is  admitted  by  the  means  ah-eady 
referred  to,  or  by  registers  placed  behind  radiators.  If  the  building 
is  heated  by  stoves,  the  fresh  air  may  be  admitted  by  inlets  running 
underneath  the  floor  between  the  joists  and  discharging  through  a 
register  near  the  stove. 

Extraction  of  foul  air  by  heat  is  usually  accomplished  by  placing 
a  separate  flue  next  to  the  chimney  flue ;  the  latter,  if  in  use  for  firing 
purposes,  creates  an  upward  current.  If  this  is  not  sufficient  it  may 
be  promoted  by  gas  jets  or  a  steam  coil  placed  in  the  flue. 

The  propulsion  and  aspiration  system  is  especially  adapted  for  all 
large  buildings  and  factories,  and  consists  of  mechanical  devices  by 
which  the  fresh  air  is  forced  into  and  distributed  throughout  the 
building  by  the  use  of  fans  or  air  propellers,  the  foul  or  objectionable 
air  being  removed  by  so-called  exhaust  fans.  A  number  of  States  have 
made  statutory  provisions  for  the  ventilation  of  workshops,  and  quite 
a  number,  including  California,  Connecticut,  Illinois,  Indiana,  Iowa, 
Maryland,  Massachusetts,  Ohio,  Oregon,  Pennsylvania,  Michigan, 
Minnesota,  Mississippi,  New  Jersey,  New  York,  South  Dakota, 
Washington,  and  Wisconsin,  require  mechanical  devices  for  the  re- 
moval of  injurious  dust  or  gases.  Of  these  States  several  lay  down 
specific  rules  concerning  the  construction  of  workbenches  and  hoods. 
The  latter  empty  into  air  shafts  connected  with  exhaust  fans,  and 
thus  extract  all  dust  and  fumes  without  material  injury  from  drafts 
to  the  operatives.  The  provisions  apply  especially  to  operations  in 
which  emery  wheels  or  belts  or  other  buffing  processes  are  employed. 
The  laws  of  the  State  of  Michigan,  acts  of  1899,  furnish  a  good  ex- 
ample of  regulations  of  this  character. 

ACT  NO.  202. — Factories  and  workshops — Blowers  for  emery  wheels,  etc. 

Section  1.  All  persons,  companies  or  corporations,  operating  any  factory  or 
workshop,  where  wheels  or  emery  belts  of  any  description  are  in  general  use, 
either  leather,  leather  covered,  felt,  canvas  paper,  cotton  or  wheels  or  belts 
rolled  or  coated  with  emery  or  corundum,  or  cotton,  wheels  used  as  buffs,  shall 
provide  the  same  with  fans  or  blowers,  or  similar  apparatus,  when  ordered  by 
the  commissioner  of  labor,  which  shall  be  placed  in  such  a  position  or  manner 
as  to  protest  [protect]  the  person  or  persons  using  the  same  from  the  particles 
of  the  dust  produced  and  caused  thereby,  and  to  carry  away  the  dust  arising 
from,  or  thrown  off  by  such  wheels,  or  belts,  while  in  operation,  directly  to  the 
outside  of  the  building  or  to  some  other  receptacle  placed  so  as  to  receive  and 
confine  such  dust,  and  the  same  shall  be  placed  in  such  factory  or  workshop 
within  three  months  after  this  act  shall  take  effect,  in  the  manner  and  accord- 
ing to  the  directions  and  specifications  as  herein,  in  this  act  set  forth :  Pro- 
vided, That  grinding  machines  upon  which  water  is  used  at  the  point  of  grind- 
ing contract  shall  be  exempt  from  the  conditions  of  this  act:  And  provided 
further,  That  this  act  shall  not  apply  to  solid  emery  wheels  used  in  sawmills 
or  planing  mills  or  other  woodworking  establishments. 

Sec.  2.  It  shall  be  the  duty  of  any  person,  company,  or  corporation  operating 
any  such  factory  or  workshop  to  provide  or  construct  such  appliances,  appa- 
ratus, machinery  or  other  things  necessary  to  carry  out  the  purpose  of  this 
act,  as  set  forth  in  the  preceding  section,  as  follows:  Each  and  every  such 
wheel  shall  be  fitted  with  a  sheet  or  cast-iron  hood  or  hopper  of  such  form  and 
so  applied  to  such  wheel  or  wheels  that  the  dust  or  refuse  therefrom  will  fall 
from  such  wheels  or  will  be  thrown  in  such  hood  or  hopper  by  centrifugal  force 
and  be  carried  off"  by  the  current  of  air  into  a  suction  pipe  attached  to  same 
hood  or  hopper. 

Sec.  3.  Each  and  every  sueh  wheel  six  inches  or  less  in  diameter  shall  be 
provided  with  a  three-inch  suction  pipe;  wheels  six  inches  to  twenty-four 
inches  in  diameter  with  four-inch  suction  pipe;  wheels  from  twenty-four 
inches  to  thirty-six  inches  in  diameter  with  a  five-inch  suction  pipe;  and  all 


86     -        REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

wheels  larger  in  diameter  than  those  stated  above  shall  be  provided  each  with 
a  suction  pipe,  not  less  than  six  inches  in  diameter.  The  suction  pipe  from 
each  wheel,  so  specified,  must  be  full  sized  to  the  main  trunk  suction  pipe,  and 
the  said  main  suction  pipe  to  which  smaller  pipes  are  attached  shall,  in  its 
diameter  and  capacity,  be  equal  to  the  combined  area  of  such  smaller  pipes 
attached  to  the  same;  and  the  discharge  pipe  from  the  exhaust  fan,  connected 
with  such  suction  pipe  or  pipes,  shall  be  as  large  or  larger  than  the  suction  pipe. 

Sec.  4.  It  shall  be  the  duty  of  any  person,  company  or  corporation  operating 
tiny  such  factory  or  workshop,  to  provide  the  necessary  fans  or  blowers  to  be 
c'ormected  with  such  pipe  or  pipes,  as  above  set  forth,  which  shall  be  run  at 
such  a  rate  of  speed  as  will  produce  a  velocity  of  air  in  such  suction  or  dis- 
charge pipes  of  at  least  nine  thousand  feet  per  minute  or  an  equivalent  suction 
or  pressure  of  air  equal  to  raising  a  column  of  water  not  less  than  five  inches 
high  in  a  U-shaped  tube.  All  branch  pipes  must  enter  the  main  trunk  pipe  at 
an  angle  of  forty-five  degrees  or  less.  The  main  suction,  or  trunk  pipe,  shall  be 
below  the  polishing  or  bufling  wheels  and  as  close  to  the  same  as  possible  and 
to  be  either  upon  the  floor  or  beneath  the  floor  on  which  the  machines  are 
placed  to  which  such  wheels  are  attached.  All  bends,  turns  or  elbows  in  such 
pipes  must  be  made  with  easy  smooth  surfaces  having  a  radius  in  the  throat 
of  not  less  than  two  diameters  of  the  pipe  on  which  they  are  connected. 

Sec  5.  It  shall  be  the  duty  of  any  factory  inspector,  sheriff,  constable  or 
prosecuting  attorney  of  any  county  in  this  State,  in  which  any  such  factory  or 
workshop  is  situated,  upon  receiving  notice  in  writing,  signed  by  any  person  or 
persons,  having  knowledge  of  such  facts,  that  such  factory  or  workshop,  is  not 
provided  with  such  appliances  as  herein  provided  for,  to  visit  any  such  factory 
or  workshop  and  inspect  the  same  and  for  such  purpose  they  are  hereby  author- 
ized to  enter  any  factory  or  workshop  in  this  State  during  working  hours,  and 
upon  ascertaining  the  facts  that  the  proprietors  or  managers  of  such  factory  or 
workshop  have  failed  to  comply  with  the  provisions  of  this  act,  to  make  com- 
plaint of  the  same  in  writing  before  a  justice  of  the  peace,  or  police  magistrate 
having  jurisdiction,  who  shall  thereupon  issue  his  warrant  directed  to  the 
owner,  manager,  or  director  in  such  factory  or  workshop,  who  shall  be  there- 
upon proceeded  against  for  the  violation  of  this  act  as  hereinafter  mentioned, 
and  it  is  made  the  duty  of  the  prosecuting  attorney  to  prosecute  all  cases 
under  this  act. 

TEMPERATURE. 

It  is  a  well-known  fact  that  the  welfare  and  capacity  for  work  of 
individuals  are  to  a  great  extent  influenced  by  the  surrounding  tem- 
perature. Reference  has  been  made  to  occupations  involving  ex- 
posure to  extremes  of  heat  and  cold,  dampness,  and  sudden  changes. 
The  human  organism  possesses  the  faculty  of  maintaining  a  uniform 
temperature,  i.  e.,  it  so  regulates  and  harmonizes  the  production  and 
the  loss  of  animal  heat  that  the  normal  temperature  of  the  blood, 
98.2°  F.  is  not  materially  affected,  and  in  this  the  skin  doubtless 
plays  the  most  important  role.  Whenever  cold  acts  upon  the  skin 
the  irritation  is  primarily  exerted  upon  the  nerves,  which  transmit  it 
to  the  central  organs  of  the  nervous  system  (the  heat-regulating 
center) ,  and  from  there  it  is  reflected  to  the  nerves  of  tlie  cutaneous 
vessels  and  muscular  fibers,  which  promptly  contracts,  and  in  con- 
sequence of  a  diminished  blood  supply  there  is  less  loss  of  heat.  If, 
on  the  other  hand,  heat  instead  of  cold  plays  upon  the  skin,  we  have 
dilatation  instead  of  contraction  of  the  vessels,  with  an  increased  sur- 
face blood  supply  and  corresponding  loss  of  heat  by  radiation  and 
conduction.  At  the  same  time  the  perspiratory  glands  are  stimulated 
to  greater  activity,  more  sweat  is  excreted  and  evaporated,  and  still 
more  heat  is  dissipated.  One  of  the  bad  effects  of  profuse  perspira- 
tion is  that  the  blood  is  deprived  of  some  of  its  constituents.  The 
blood  is  taken  away  too  long  from  the  internal  organs ;  the  proper  dis- 
tribution of  the  blood  supply  is  interfered  with,  and  in  consequence 


REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  87 

tone  and  nutrition  of  the  stomach,  lungs,  heart,  and  other  internal 
organs  is  lowered.  We  lose  our  appetite  and  suffer  from  indigestion ; 
the  tone  and  nutrition  of  the  stomach,  lungs,  heart,  and  other  internal 
enervation,  and  the  system  in  consequence  is  rendered  more  suscep- 
tible to  disease. 

While  the  human  organism  endeavors  to  adapt  itself  to  extremes 
of  heat  and  cold,  the  faculty  of  the  body  to  maintain  the  equilibrium 
is  by  no  means  unlimited,  and  the  heat-regulating  center  is  liable  to 
fail  or  become  paralyzed  if  imposed  upon  too  long  or  too  frequently. 
This  is  especially  the  case  during  sudden  changes  of  temperature. 
It  is  the  abruptness  which  offends  the  peripheral  nerves,  and  the 
^eater  the  abruptness  the  more  intensive  will  be  the  irritation  which 
IS  transmitted  by  reflex  action  to  other  parts  of  the  body,  usually  the 
weakest  parts,  and  may  result  in  driving  the  blood  to  internal  organs, 
causing  congestion  and  other  mischief.  Then  again  a  cold  draft 
playing  on  the  cheek  may  cause  neuralgia,  paralysis,  sore  throat, 
bronchitis,  or  pneumonia,  showing  that  cold  applied  locally  may 
excite  disease  in  the  neighborhood  of  its  application  or  in  distant 
organs,  and  finally  it  may  produce  disease  by  checking  the  secretions 
of  the  skin. 

The  most  agreeable  temperature  for  average  healthy  adults  prop- 
erly clothed  and  performing  light  work  is  between  65°  and  70°  F., 
and  every  effort  should  be  made  to  avoid  extremes  of  heat  and  cold. 
Much  may  be  done  to  reduce  the  temperature  of  workshops  by  forced 
ventilation  and  a  supply  of  cool,  fresh  air.  The  windows  should  be 
kept  open  during  the  summer  nights,  so  that  the  rooms  may  be  thor- 
oughly flushed  with  fresh  and  cool  air. 

HUMIDITY  OF  THE  AIR. 

The  atmosphere  always  contains  a  certain  amount  of  water  in  the 
state  of  vapor,  which  varies  from  30  per  cent  to  complete  saturation, 
or,  according  to  temperature,  from  1  to  12  grains  in  a  cubic  foot  of 
air.  The  degree  of  atmospheric  humidity  is  of  special  hygienic 
importance,  as  it  influences  to  a  great  extent  the  cutaneous  and  pul- 
monary exhalation  of  vapor  and  in  consequence  also  affects  the  ani- 
mal temperature.  The  average  daily  amount  of  water  eliminated 
by  the  skin  is  2J  pounds,  and  about  10  ounces  by  the  lungs.  It  is 
evident  that  when  the  air  is  damp  it  lessens  evaporation,  as  it  pos- 
sesses little  drying  power,  and  the  water  from  the  skin  and  lungs 
is  with  difficulty  evaporated.  The  evaporation  of  perspiration,  by 
which  much  heat  is  rendered  latent,  is  one  of  the  chief  sources  of 
cooling  of  the  body.  Consequently  when  the  air  is  hot  and  moist 
the  humidity  tends  to  increase  the  effects  of  the  heat,  the  blood  is 
with  difficulty  kept  at  its  proper  temperature,  and  all  the  disagree- 
able effects  of  a  high  temperature  are  intensified.  This  condition 
may  be  so  aggravated  that  the  temperature  of  the  body  exceeds  the 
normal  degree  and  causes  our  cases  of  so-called  heat  stroke  or  heat 
exhaustion,  which  occurs  especially  on  hot,  sultry  days. 

A  damp,  cold,  or  chilly  air  also  produces  mischief,  as  it  abstracts 
an  undue  amount  of  animal  heat,  lowers  the  general  vitality  of  the 
system,  and  favors  the  development  of  diseases  of  the  respiratory 
passages,  neuralgic  and  rheumatic  affections,  and  aggravates  the 
severity  of  such  attacks.    We  may  conclude,  therefore,  that  excessive 


88  REPORTS   OP  THE  PRESIDENT'S  HOMES  COMMISSION. 

humidity  tends  to  intensify  the  effects  of  both  heat  and  cold.  On  the 
other  hand,  excessive  dryness  of  the  air  is  also  harmful;  it  increases 
evaporation,  the  skin  becomes  dry  and  chapped,  and  the  mucous 
membranes  of  the  mouth,  eyes,  and  respiratory  passages  are  irritated, 
causing  so-called  catarrhal  conditions.  For  all  these  reasons  an  aver- 
age relative  humidity  between  65  and  75  per  cent  has  been  found  most 
healthful,  and  efforts  should  be  made  to  maintain  such  a  standard 
whenever  practicable.  Apart  from  methods  calculated  to  accomplish 
these  results,  reliable  thermometers  and  hygrometers  are  required  to 
secure  efficient  control.  State  legislators  would  do  well,  instead  of 
making  a  general  provision  for  sufficient  heat,  moisture,  etc.,  to  pre- 
scribe a  standard,  at  least  in  industries  w^here  such  standards  are 
practicable  and  can  be  reasonably  enforced. 

LIGHTING. 

The  natural  light  in  workshops  should  be  sufficient  so  that  the  eyes 
need  not  be  strained  even  on  cloudy  days.  When  the  light  is  defect- 
ive the  objects  have  to  be  brought  too  near.  The  eyes  in  consequence 
converge,  and  the  muscular  strain  thus  induced  causes  a  gradual 
elongation  of  the  anterior-posterior  axis  of  the  eyeball,  and  near- 
sightedness results.  In  addition  it  is  believed  by  specialists  that  80 
to  90  per  cent  of  the  headaches  are  caused  by  eye  strain.  It  has  been 
found  by  Putzeys*  that  the  natural  lighting  in  temperate  climates 
will  usually  come  up  to  hygienic  requirements  when  the  area  of  win- 
dows, exclusive  of  sash  frames,  equals  one-sixth  of  the  floor  space. 
In  order  that  the  light  may  penetrate  the  deeper  portions  of  the 
room,  the  windows  should  reach  almost  to  the  ceiling  and  the  glass 
should  be  either  pure  white  ribbed  or  prismatic  and  kept  clean.  Wis- 
consin is  apparently  the  only  State  which  has  undertaken  to  legislate 
specifically  upon  this  point,  as  section  3  of  chapter  79,  acts  of  1899, 
provides : 

Every  window  shall  have  not  less  than  12  square  feet  in  superficial  area,  and 
the  entire  area  of  window  surface  shall  not  be  less  than  12  per  cent  of  the  floor 
space  of  such  room. 

The  difficulty  of  securing  a  sufficient  amount  of  daylight  in  build- 
ings located  on  narrow  streets  surrounded  by  tall  buildings  has  been 
partly  overcome  by  glass  building  blocks  8  bjr  6  by  2^  inches,  with 
an  air  chamber  in  the  center,  used  instead  of  brick  or  stone,  in  connec- 
tion with  steel-frame  construction,  but  more  particularly  by  the  intro- 
duction of  prismatic  glass,  which  refracts  and  diffuses  the  light. 

ARTIFICIAL  LIGHT. 

No  matter  how  obtained,  artificial  li^ht  differs  from  daylight  in 
this,  that  it  does  not  furnish  a  pure  white  light,  the  prevailing  rays 
being  red,  yellow,  or  violet.  Whatever  difference  or  opinion  there 
may  be  as  to  the  color  best  suited  to  our  eyes,  we  know  that  our 
vision  is  most  perfect  under  the  influence  of  a  white  light,  and  this 
ought  to  be  a  good  criterion.  One  of  the  disadvantages  of  all  low- 
power  illuminants  is  that  the  light  is  never  as  bright  as  daylight,  in- 
volving, therefore,  closer  application  of  the  eyes  and  consequent  strain 

«  Cited  by  Munson,  Military  Hygiene,  1901,  p.  521. 


EEPORTS   OP    THE   PKESIDENT  S   HOMES   COMMISSION.  89 

of  the  muscles  of  the  eyeball.  These  remarks  are  hardly  applicable 
to  the  electric  arc  light  and  the  Welsbach  gas  burner,  the  rays  of 
which,  like  the  direct  solar  rays,  may  indeed  be  so  glaring  as  to  cause 
undue  irritation  of  the  retina. 

Another  harmful  effect  of  artificial  illumination  is  the  unsteady  or 
flickering  character,  especially  seen  in  the  electric  arc  light,  and 
which  on  account  of  the  abrupt  changes  is  likely  to  irritate  the  retina. 
Another  disadvantage  is  that  the  ordinary  illuminants,  except  the 
electric  light,  tend  to  vitiate  the  air  by  the  products  of  combustion, 
and  also  affect  the  temperature  and  humidity  of  the  air  by  the  heat 
evolved. 

The  requirements  of  a  hygienic  light  are  that  it  should  be  as  near 
as  possible  the  color  of  the  sunlight,  sufficiently  ample  but  not  too 
glaring;  it  should  be  steady,  and  instead  of  deteriorating  the  air  it 
should  as  far  as  practicable  be  utilized  to  promote  ventilation;  nor 
should  the  heat  evolved  be  sufficiently  intense  to  be  a  source  of  dis- 
comfort to  the  inmates  in  warm  weather.  The  most  common  methods 
of  lighting  now  employed  are  the  electric  incandescent  lamps,  arc 
lights,  mercury-vapor  lights  and  electric  bulbs,  gaslight,  and  kero- 
sene lamps.  Of  these,  the  electric  lights,  especially  the  mercury-vapor 
lights,  are  superior  to  gas  or  other  illuminants  because  there  is  little 
or  no  danger  from  fire,  there  are  no  products  of  combustion,  hence  no 
pollution  of  the  air,  nor  are  the  temperature  and  humidity  of  the 
room  affected  to  any  perceptible  extent.  These  advantages  over  gas 
or  kerosene  are  of  special  importance  to  the  inmates  of  the  buildings 
where  the  question  of  fresh  air  and  temperature  plays  an  important 
role;  hence  many  industrial  plants  find  it  profitable  to  install  the 
very  best  type  of  electric  lighting,  and  thereby  save  time  and  money 
by  the  prevention  of  sickness  and  accidents  among  their  employees. 
Next  to  the  electric  light,  gas,  especially  in  connection  with  a  Wels- 
bach or  Siemen's  burner,  or  the  acetylene  gas,  offers  the  next  best 
choice.  In  the  absence  of  either  electric  or  gas  light,  kerosene  with  a 
high  flashing  point  should  be  preferred  over  other  illuminants.  In 
all  such  instances  suitable  outlets  for  tlie  products  of  combustion 
should  be  provided. 

White,  clean  ceilings  and  walls  will  be  of  great  service  not  only  in 
solving  the  question  of  light,  but  also  in  general  sanitation,  and  a 
number  of  States,  notably  Indiana,  Kentucky,  Missouri,  New  Jersey, 
and  New  York,  require  the  walls  to  be  limewashed  or  painted. 

The  sufficiency  of  artificial  lighting  may  be  approximately  deter- 
mined by  observation,  and  quite  accurately  by  the  employment  of 
Bunsen's  method  and  his  photometer.  In  this  country  and  England, 
according  to  Munson,  "  the  unit  adopted  for  the  measurement  and 
comparison  of  lights  is  a  No.  6  sperm  candle  burning  8  grams  per 
hour  and  giving  out  a  light  known  as  '  1  candlepower.' "  Such  a 
candle  contains  on  analysis  carbon  80  per  cent,  hydrogen  13  per  cent, 
oxygen  6  per  cent,  and  in  combustion  yields  equal  volumes  of  car- 
bonic acid  and  watery  vapor  to  the  air,  namely,  0.41  cubic  foot. 

PREVENTION   OF   ACCIDENTS. 

About  22  States  have  taken  steps  to  reduce  accidents  to  a  mini- 
mum. For  this  purpose  they  have  enacted  laws  concerning  employers' 
liability  if  they  fail  to  provide  safety  devices  for  the  movable  and 


90  REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

dangerous  parts  of  machinery.  Apart  from  proper  screening,  belting, 
etc.,  the  use  of  respirators,  wire  masks,  and  goggles  are  absolutely 
essential  for  the  prevention  of  accidents  or  injuries  in  many  employ- 
ments. At  least  27  States  require  some  form  of  protection  in  case  of 
fire,  by  means  of  fire  escapes  and  doors  swinging  outwardly,  while  a 
respectable  number  also  insist  upon  inspection  and  registration  of 
steam  boilers. 

A  careful  inspection  of  steam  boilers  and  examination  of  engineers 
have  materially  lessened  the  dangers  from  boiler  explosions,  so  that 
in  England  there  is  only  about  1  explosion  in  6,200  registered  boilers. 

It  has  been  suggested  that  employees  who  come  in  contact  with 
moving  machinery  should  provide  themselves  with  suitable  clothing, 
so  fitted  and  arranged  as  to  reduce  the  dangers  to  a  minimum.  There 
is  an  endless  variety  of  suitable  patterns  in  the  market,  of  which  the 
snug-fitting  duck  union  suits  properly  buttoned  and  adjusted  are  the 
best.  Asbestos  clothing  has  been  recommended  for  firemen  and  fur- 
nace operators;  but  as  it  is  rather  heavy,  light  leather  suits  or  aprons 
are  preferable,  while  even  ordinary  clothing  may  be  rendered  practi- 
cally noninflammable  by  chemical  treatment. 

The  following  views  of  Mr.  Frederick  Hoffman  <»  in  his  excellent 
article  on  industrial  accidents  are  reproduced : 

The  present  state  of  American  industrial  accident  statistics  does  not  warrant 
final  conclusions  regarding  the  true  rate  of  the  risk  in  different  employments 
nor  of  the  approximate  determination  of  the  occupation  hazard,  by  degree  of 
injury,  for  the  more  important  industrial  employments.  Most  of  the  present 
information  is  limited  to  the  facts  of  accidental  death  or  injuries  generally, 
and  while  such  data  have  their  value  they  require  to  be  made  more  specific 
to  throw  light  upon  the  larger  problem  of  accident  prevention  and  working- 
men's  compensation  for  industrial  casualties.  The  importance  of  such  infor- 
mation has  been  clearly  brought  out  in  an  address  on  "  Valuation,  in  Actions 
for  Damages  for  Negligence,  of  Human  Life,  Destroyed  or  Impaired,"  by 
Miles  M.  Dawson,  before  the  International  Actuarial  Congress  in  1903.*  For 
insurance  and  other  purposes,  however,  the  data  presented  in  this  article  will 
prove  useful  and  emphasize  the  more  dangerous  trades  and  the  present  ten- 
dency toward  an  increase  or  decrease  in  the  risk  of  accidental  injury  in  the 
more  important  dangerous  occupations.''  To  the  workingman  himself  there 
is  no  more  important  problem  than  the  most  effective  protection  of  his  life  and 
health  against  the  accident  risk  inherent  in,  or  incidental  to,  the  occupation  in 
which  he  is  employed.  Much  that  could  be  done  for  his  protection  is  still 
neglected,  though  many  important  and  far-reaching  improvements  have  been 
introduced  in  factory  practice  during  the  last  decade.  Accurate  statistics  alone 
can  furnish  a  reasonable  basis  for  reform.  The  possibilities  for  successful 
accident  prevention  have  been  clearly  demonstrated  in  the  experience  of  foreign 
countries  and  the  exhibition  of  safety  devices  of  the  American  Institute  for 
Social  Service. 

SOCIAL  ASPECTS  OF  THE  ACCmENT  PROBLEM. 

"  The  facts  presented  in  this  article  warrant  the  conclusion  that  the 
casualty  risk  in  American  industries  is  a  most  serious  one,  toward 
the  reduction  of  which  every  effort  should  be  made.    At  least  a  more 

«  Bulletin  of  the  Bureau  of  Labor  No.  78.  Washington,  D.  C,  September,  1908. 

*  Proceedings  Fourth  International  Congress  of  Actuaries,  1904,  Vol.  I,  p.  929. 

"A  useful  and  suggestive  work  on  the  prevention  of  accidents  in  industry 
has  been  published  by  the  German  Association  of  Trade  Unions  entitled :  Un- 
fallverhiitungsvorschriften,  herausgegeben  vom  Verbande  Deutscher  Berufs- 
genossenschaften,  Berlin,  1900.  Mention  may  also  be  made  of  a  valuable 
treatise  on  definition  of  invalidity  under  the  title :  Der  Begrifif  der  Erwerbsun- 
fahigkeit  auf  dem  Gebiete  des  Versicherungswesens,  by  H.  Siefart,  Berlin.  1906. 


BEPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  91 

earnest  effort  should  be  made  to  profit  by  the  industrial  methods  of 
European  countries.  Granting  that  the  underlying  conditions  are 
often  quite  different,  and  that  many  of  our  industrial  accidents  are 
the  result  of  ignorance,  reckless  indifference,  or  carelessness,  the  fact 
remains  that  an  immense  amount  of  human  life  is  wasted  and  a  vast 
amount  of  injury  is  done  to  health  and  strength,  with  resulting  phys- 
ical impairment,  which  has  a  very  considerable  economic  value  to  the 
nation  as  a  whole.  If,  for  illustration,  the  accident  liability  of  em- 
ployees in  coal  mines  in  the  United  States  were  reduced  from  3.10  per 
1,000,  which  was  the  average  annual  rate  for  the  period  1897-1906,* 
to  1.29  per  1,000,  the  average  rate  in  the  United  Kingdom  for  the 
same  period,^  the  annual  saving  in  human  life  would  be  915.  If 
the  rate  of  casualties  of  railway  employees  in  this  country  were  re- 
duced from  2.50  per  1,000,  which  was  the  average  annual  rate  for 
1897-1906,"  to  0.98  per  1,000,  the  average  for  the  German  Empire 
for  the  same  period,^  the  annual  saving  would  be  1,735  valuable 
human  lives.  As  stated  at  the  outset,  upon  a  conservative  estimate, 
the  total  mortality  from  accidents  in  the  United  States  among  adult 
male  wage-earners  is  between  30,000  and  35,000,  of  which  it  should 
not  be  impossible  to  save  at  least  one-third  and  perhaps  one-half  by 
intelligent  and  rational  methods  of  factory  inspection,  legislation, 
and  control.  In  addition  there  were  approximately  not  much  less 
than  two  million  nonfatal  accidents,  that  not  only  involve  a  vast 
amount  of  human  suffering  and  sorrow,  but  materially  curtail  the 
normal  longevity  among  those  exposed  to  the  often  needless  risk  of 
industrial  casualties."     (Hoffman.) 

MISCELLANEOUS  SANITARY  PROVISIONS. 

A  number  of  States  have  enacted  laws  concerning  general  cleanli- 
ness of  factories  and  workshops.  Most  of  the  factory  laws  make  pro- 
visions for  the  necessary  sanitary  conveniences,  such  as  privies,  water- 
closets,  and  urinals,  and  where  men  and  women  are  employed  separate 
dressing  rooms  and  water-closets  are  called  for.  Some  of  the  States, 
like  Wisconsin,  for  example,  specify  "  that  when  the  number  employed 
is  more  than  25  of  either  sex  there  shall  be  provided  an  additional 
water-closet  for  such  sex  up  to  the  number  of  50  persons,  and  above 
that  number  in  the  same  ratio."  The  author  believes  that  there  should 
be  at  least  one  water-closet  or  privy  for  every  20  employees. 

A  large  number  of  States  make  seats  for  female  employees,  wash 
rooins,  and  dressing  rooms  obligator}'-,  and  not  a  few  insist  upon  sepa- 
rate provisions  for  the  sexes.  The  importance  of  personal  cleanliness 
has  been  pointed  out.  In  certain  occupations  the  washing  of  the  hands 
before  eating  is  important,  and  in  occupations  involving  exposure  to 
poisonous  dust  or  agents  the  employment  of  a  general  bath  should  be 
encouraged  by  insisting  upon  the  introduction  of  suitable  shower 
baths. 

*  Computed  from  the  mine  inspectors'  reports  of  the  various  States. 

^  Computed  from  statistics  included  in  the  annual  reports  of  the  Home  Office 
entitled  "Mines  and  Quarries:  General  Reports  and  Statistics,  London." 

^  Computed  from  statistics  shown  in  the  Report  of  the  Interstate  Commerce 
Commission,  Statistics  of  Railways,  1906,  pp.  42,  109. 

'^Computed  from  Statistisches  Jahrbuch  fiir  das  Deutsche  Reich,  1908,  pp. 
85-88. 


92  REPORTS  OF  THE  PRESIDENT'S  HOMES  COMMISSION. 

A  few  States,  notably  Massachusetts  and  Rhode  Island,  make  pro- 
visions for  "  fresh  drinking  water  of  good  quality."  The  former  also 
regulates  the  spitting  habit  by  insisting  upon  suitable  spittoons. 
These  and  other  questions,  like  clothes  lockers  and  lunch  rooms,  and 
the  time  allowed  for  the  noonday  meals,  which  is  already  regulated 
in  a  number  of  States,  should  receive  universal  attention.  Much 
industrial  legislation  has  been  enacted  by  state  legislatures  during 
the  past  ten  years.  Commendable  progress  has  been  made  in  the  pro- 
vision of  ventilation,  heating,  lighting,  removal  of  dust,  and  general 
sanitation  of  workshops.  The  need  for  additional  improvement  is 
shown  by  the  Massachusetts  board  of  health's  survey  of  the  work  in 
that  State,  which  has  generally  been  in  the  lead  in  factory  laws. 

The  report  of  the  state  board  of  health,  on  page  4,  reads : 

In  many  [industries]  the  conditions  were  found  to  be  satisfactory.  In  the 
emery  and  corundum,  sandpaper,  and  certain  other  industries  more  attention 
should  be  given  to  keeping  the  dust  away  from  the  mouth  and  nostrils  of  the 
workmen.  In  the  rag  dusting,  sorting,  and  cutting  rooms  of  some  paper  mills 
very  objectionable  amounts  of  dust  were  found,  with  some  pale  and  sickly  ap- 
pearing operatives ;  but  there  are  mills  using  the  same  kind  of  stock  where  the 
dust  is  kept  away  from  the  employees  in  a  satisfactory  manner,  and  much  im- 
provement is  practicable  in  the  former  class. 

The  same  remarks  are  applicable  to  the  textile  industries,  and  the 
hope  is  expressed  that  the  unsatisfactory  conditions  found  in  the 
minority  of  establishments  will  be  raised  to"  those  which  are  now  found 
to  be  good. 

Reference  Kas  already  been  made  in  these  pages  to  the  conditions 
found  in  machine  shops,  the  cutlery  and  tool  industry,  cigar,  rubber, 
boot  and  shoe,  and  other  industries  examined.  In  the  boot  and  shoe 
industry  comment  is  made  upon  "  four  conditions  which  can  be  and 
ought  to  be  remedied."  These  are  poor  ventilation,  inadequate  re- 
moval of  dust  from  machines,  the  conditions  of  water-closets,  and  spit 
upon  the  floors.  In  the  majority  of  factories  visited  the  ventilation 
was  found  to  be  poor,  and  in  many  of  them  distinctly  bad.  Of  the 
rooms  not  especially  dusty,  102  were  badly  ventilated  and  26  were 
overcrowded.  *  *  *  Of  84  of  the  many  dusty  rooms  reported,  40  were 
also  overcrowded,  35  were  dark,  21  were  overheated,  and  18  were  over- 
crowded, dark,  and  overheated. 

"  In  more  than  one-third  of  the  factories  visited  the  conditions  of 
water-closets  were  not  commendable;  most  of  them  were  dark  and 
dirty  to  very  dirty.  In  50  establishments  no  spitting  was  noticed,  in 
173  there  was  some,  in  115  considerable,  and  in  35  much." 

"  In  some  establishments  lunch  rooms  are  provided,  where  employ- 
ees may  eat  the  luncheon  they  have  brought  or  may  buy  one ;  in  much 
the  larger  number  the  employees  eat  in  the  workrooms.  *  *  *  In  85 
factories,  or  23  per  cent  of  those  visited,  a  considerable  proportion  of 
the  employees  are  noticeably  pale  and  unhealthy." 

In  discussing  the  following  provision  in  the  Massachusetts  laws, 
"All  factories  shall  be  kept  clean,"  the  state  board  of  health  very 
properly  points  out  that  "  what  is  clean  in  an  ax-grinding  factory 
would  not  be  clean  in  a  silk  mill ;  but  the  law  makes  no  distinction, 
and  the  judgment  of  the  officer  can  not  be  received  as  law."  The 
board  considers  it  impossible  to  specify  in  any  law  a  standard  of 
cleanliness  applicable  to  all  industries,  and  advises  "  that  the  officer 
should  be  authorized  to  hold  all  factories  in  any  industry  up  to  the 


REPORTS   OF   THE   PRESIDENT'S   HOMES   COMMISSION.  93 

standard  of  cleanliness  which  he  finds  maintained  in  the  factories  in 
the  same  industry  and  using  the  same  grade  of  stock  which  are  the 
cleanest."  The  same  method  is  recommended  for  the  enforcement  of 
standards  in  other  directions,  subject  to  an  appeal  to  the  state  board 
of  health. 

LODGING  HOUSES  AND  SLEEPING  QUARTERS. 

It  not  infrequently  happens  that  large  industrial  plants  and  con- 
tractors provide  board  and  lodging  for  their  unmarried  employees. 
Again,  in  a  number  of  the  smaller  industries  the  employees  not  infre- 
quently board  with  the  family  and  are  obliged  to  sleep  in  objection- 
able rooms.  All  such  provisions  should  come  up  to  a  reasonable 
standard  as  regards  salubrity,  air  space,  light,  heat,  and  ventilation, 
and  separate  provisions  should  be  required  for  males  and  females  and 
youthful  employees.  Lodging  houses  should  come  up  to  a  certain 
standard,  and  wash  and  bath  rooms  and  suitable  tiolet  facilities 
should  be  provided.  Special  attention  should  be  paid  to  general 
cleanliness  within  and  without  quarters  for  working  parties,  and  to 
the  character  and  preparation  of  food. 

PERMANENT   EXPOSITIONS    DEVOTED    TO   INDUSTRIAL    AND    SOCIAL   BETTER- 
MENT or  WAGE-EARNERS. 

It  will  require  time  and  patience  to  bring  employers  and  workers 
to  a  full  realization  of  the  dangers  incident  to  the  various  occupations 
and  to  a  thorough  appreciation  of  the  methods  which  have  been  pro- 
posed in  the  way  of  factory  sanitation,  safety  devices,  ete.  Good  re- 
sults abroad  have  been  accomplished  by  a  permanent  exposition  de- 
voted to  social  and  industrial  betterm'ent  for  wage-earners.  Such  an 
exposition  was  provided  for  by  the  German  Parliament  a  few  years 
ago,  and  a  similar  effort  is  now  being  made  in  the  city  of  New  York. 
The  German  exposition  occupies  a  building  specially  erected  for  the 
purpose  at  Charlottenburg,  a  suburb  of  Berlin,  and  here  every  safety 
appliance  which  inventive  genius  has  devised  can  be  seen  in  practical 
operation.  The  different  labor  unions  appear  to  profit  immensely  by 
the  special  lectures  and  demonstrations  which  are  given  on  Sundays, 
or,  upon  request,  at  any  convenient  time,  by  men  formerly  employed 
in  "  dangerous  occupations."  Apart  from  safety  devices  for  ma- 
chinery and  appliances  for  removal  of  dust  and  injurious  gases,  all 
improved  methods  calculated  to  diminish  danger,  as,  for  example,  in 
the  manufacture  of  white  lead,  etc.,  are  illustrated  by  models  and  de- 
scriptive text,  printed  leaflets  being  distributed  free  of  charge. 
Here,  too,  may  be  seen  the  best  and  most  recent  types  of  respirators, 
wire  masks,  goggles,  illuminating  appliances,  and  safety  working  suits. 
Inventors  and  designers  esteem  it  a  great  honor  to  have  their  prod- 
ucts admitted  for  exposition.  Only  meritorious  objects  are  displayed, 
and  they  are  replaced  by  the  newer  and  more  satisfactory  types. 
One  of  the  most  interesting  collections  consists  of  a  series  of  bottles 
containing  different  varieties  of  dust,  a  series  of  photographs  show- 
ing the  microscopical  character  of  this  dust,  and,  last  but  not  least, 
anatomical  specimens  and  microscopical  slides  showing  the  effects  of 
dust  upon  the  air-passages  and  lungs  of  the  human  subject.  Models, 
plans,  and  photographs  of  tenements  and  model  homes  for  wage- 


94  REPORTS   OF  THE  PRESIDENT'S  HOMES  COMMISSION. 

earners,  exterior  and  interior  decorations,  literature,  and  charts  con- 
cerning industrial  betterment,  all  find  a  prominent  place  in  the  ex- 
hibit. The  display  of  foodstuffs,  their  nutritive  and  economic  value, 
together  with  instructive  leaflets,  form  part  of  this  interesting  expo- 
sition. A  popular  pamphlet  seen  at  the  exposition  in  September, 
1907  was  compiled  by  Professor  Kalle  and  Doctor  Schellenberg, 
entitled  "  How  to  keep  well  and  capacitated  for  work,"  which  is  sold 
by  the  Society  for  Popular  Education  at  2^  cents  a  copy,  over  470,000 
so  far  having  been  sold. 

Chapter  XIV. 

WHAT  THE  FEDERAL  GOVERNMENT  MAY  DO   FOR  THE  PROMOTION 
OF  THE  WELFARE  OF  ITS  EMPLOYEES,  ETC. 

Much  excellent  work  has  been  and  is  being  done  by  the  United 
States  Bureau  of  Labor  in  the  collection  and  publication  of  facts  con- 
cerning every  phase  of  industrial  and  social  betterment.  These  bul- 
letins are  issued  bimonthly,  and  if  carefully  read  can  not  fail  to  exert 
a  tremendous  educational  influence  upon  those  for  whom  they  are  pri- 
marily intended,  viz,  the  wage-earners  and  employers.  But  while 
much  has  been  achieved  more  remains  to  be  accomplished.  It  seems 
to  the  writer  that  apart  from  establishing,  in  connection  with  the  Na- 
tional Museum,  a  permanent  exposition  relating  to  industrial  and 
social  betterment  of  wage-earners,  it  is  clearly  the  duty  of  the  Fed- 
eral Government  to  establish  and  adopt  a  standard  of  industrial 
hygiene  for  all  the  government  workshops. 

President  Roosevelt,  in  a  message  to  Congress  December,  1907,  has 
said : 

The  National  Government  should  be  a  model  employer.  It  should  demand  the 
highest  quality  of  service  from  each  of  its  employees  and  it  should  care  for 
all  of  them  properly  in  return.  Congress  should  adopt  legislation  providing  for 
limited  but  definite  compensation  for  accidents  to  all  vi'orkmen  within  the  scope 
of  the  federal  power,  including  employees  of  navy-yards  and  arsenals. 

We  regret  to  say  that  with  the  possible  exception  of  the  extraor- 
dinary efforts  and  special  precautions  exercised  to  protect  the  health 
and  general  welfare  of  the  employees  in  the  operations  connected  with 
the  construction  of  the  canal  on  the  Isthmus  of  Panama,  the  sanita- 
tion of  offices  and  workshops  in  this  country  proper,  for  government 
employees,  is  not  even  on  a  par  with  some  of  the  best  private  indus- 
trial concerns.  There  can  be  no  question  that  model  government 
workshops  and  efforts  for  the  promotion  of  the  general  welfare  of 
the  employees  would  prove  a  salutary  precept  and  example.  The 
General  Government  is  not  in  a  position  to  legislate  for  the  States, 
but  it  can  at  least  enact  a  model  labor  and  factory  law  for  the  Dis- 
trict of  Columbia,  and  all  of  the  workshops  connected  witli  the  army 
and  navy  arsenals,  gun  factories,  powder  depots,  clothing  depots,  and 
the  immense  army  of  labor  employed  on  the  Isthmus  of  Panama. 

Apart  from  strictly  sanitary  measures  for  the  promotion  and  pres- 
ervation of  health,  the  Government,  as  a  model  employer,  should 
provide  some  adequate  relief  in  case  of  sickness,  accidents,  or  disa- 
bility from  disease  or  injuries  contracted  in  the  line  of  duty.  As  it 
is  now,  the  Government  merely  grants  one  month's  sick  leave  to  oflfi- 


KEPORTS   OF    THE   PRESIDENT'S   HOMES   COMMISSION.  95 

cials  and  office  employees,  none  to  workmen  employed  in  government 
shops,  and  in  case  of  accidents  the  employee  or  his  dependents  have 
no  remedy  except  recourse  to  the  courts  of  law. 

While  it  is  true  that  government  employees  in  many  instances  have 
banded  together  for  the  purpose  of  establishing  sick  benefit  and  relief 
associations,  such  organizations  lack  official  control  and  do  not  always 
embody  the  most  advanced  principles  of  social  and  political  economy. 


INDUSTRIAL  INSURANCE. 

For  reasons  briefly  stated,  the  Federal  Government  would  do  a  wise 
act,  by  creating  the  so-called  industrial  insurance  system,  for  the  sick, 
for  accidents,  disability  and  old  age,  for  its  own  employees  and  others 
in  the  District  of  Columbia,  and  thus  initiating  a  system  which  has 
proved  to  be  a  veritable  blessing  in  many  of  the  European  countries. 
Any  one  who  desires  to  become  familiar  with  the  "  German  working- 
men's  insurance  "  should  not  fail  to  read  a  digest  in  the  Bulletin  of 
the  Bureau  of  Labor  No.  53,  July,  1904,  page  941,  and  Professor 
Henderson's  "  Summary  of  European  Laws  on  Industrial  Insurance." 
(Charities,  December  7,  1907,  p.  1191.)  « 

Under  the  operation  of  the  German  law,  enacted  in  1883,  all  work- 
men employed  in  commerce,  industry  and  the  handicraft  trades,  and 
whose  wage  is  less  than  2,000  marks  (about  $480)  must  be  insured. 
By  special  regulations  this  requirement  may  be  extended  to  agricul- 
tural and  household  employees.  To  secure  the  enrollment  of  indi- 
viduals "  for  sick  benefits,"  the  employers  in  the  industries  subject 
to  the  law  are  required  to  send  to  the  proper  insurance  fund  the 
names  of  each  person  who  enters  or  leaves  their  service. 

The  income  of  the  sick  funds  is  derived  from  the  dues  of  members — 
the  amount  is  fixed  by  each  local  association,  but  can  not  exceed  6 
per  cent  of  the  members'  wages.  The  employee,  pays  two-thirds  of 
the  dues  and  the  employer  one-third.  The  employee's  share  is  de- 
ducted from  his  wages  and  paid  direct  to  the  insurance  fund  by  the 
employei;,  when  he  remits  his  own  share. 

The  benefits  offered  by  the  sick  funds  vary  in  amount,  but  all  of 
them  are  required  to  provide  the  following  as  a  minimum:  (1)  Free 
medicine,  attendance,  and  treatment.  (2)  In  case  the  sickness  causes 
inability  to  work,  the  fund  pays  a  sick  benefit  equal  to  one-half  the 
wage  rate  which  was  used  in  calculating  the  member's  dues.  This 
benefit  begins  the  third  day  after  the  disability  sets  in,  and  continues 
for  26  weeks.  Instead  of  receiving  medical  treatment  at  home  a 
member  is  entitled  to  treatment  at  a  hospital,  in  which  case  an  amount 
not  exceeding  one-half  of  his  daily  wage  is  paid  to  his  dependents. 
Female  members  receive  similar  benefits  for  a  period  of  six  weeks  fol- 
lowing confinement.  (3)  In  case  of  death,  a  funeral  benefit  equal  to 
twenty  times  the  amount  of  his  daily  wage  is  paid  to  the  heirs  of  a 
member. 

In  1904  there  were  22,912  local  sick  and  miners'  provident  associa- 
tions in  the  German  Empire  with  11,400,000  members,  practically 

«  The  writer  is  indebted  to  these  sources  for  much  of  the  informatioa  on  this 
subject  and  gratefully  acknowledges  this  indebtedness. 


96  REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

one-fifth  of  the  population.  The  disbursements  amounted  to  237,- 
107,000  marks  (about  $56,470,000).  Of  this  amount  106,000,000 
marks  (about  $25,238,000)  was  paid  for  sick  benefits,  and  the  remain- 
der for  medical  and  hospital  treatment,  convalescence  and  funeral 
benefits. 

ACCIDENT    INSUBANCE. 

Under  the  provisions  of  the  laws  of  1884, 1887,  and  1900,  all  work- 
ingmen  and  technical  experts  engaged  in  industry,  agriculture,  for- 
estry, transportation,  and  coast  fisheries  earning  less  than  3,000  marks 
(or  about  $715)  per  annum,  are  required  to  be  insured  against  acci- 
dent. By  special  enactment  it  may  be  extended  to  foremen  and  petty 
emplo3'ers  with  more  than  3,000  marks  income.  This  form  of  insur- 
ance is  administered  by  associations  of  employers  known  as  "  mutual 
trades  associations,"  subject  to  federal  supervision.  In  1904  there 
were  114  associations,  including  5,300,000  establishments  and  17,- 
500,000  workmen.  The  workingman's  share  of  the  expense  of  the 
accident  insurance  consists  of  the  benefits  paid  out  of  the  sick  insur- 
ance fund  to  the  injured  person  during  the  first  thirteen  weeks  of  dis- 
ability. The  share  of  the  employer  is  determined  from  the  amount 
of  his  pay  roll  and  the  danger  rate  of  occupation.  Beginning  with 
the  fourteenth  week  the  trades  association  provides  (1)  free  medical 
treatment;  (2)  a  pension  during  the  continuation  of  the  disability, 
whether  the  disability  is  partial  or  complete.  In  case  of  complete 
disability  the  pension  is  equal  to  two-thirds  of  the  earnings  of  the  in- 
jured person;  in  case  of  partial  disability  the  insured  receives  a  frac- 
tion of  the  above  pension,  proportioned  to  the  degree  of  disability. 

In  case  of  a  fatal  accident,  the  law  provides  for  (1)  a  funeral 
benefit  of  not  less  than  $12;  (2)  a  pension  to  the  dependents  of  the 
deceased,  including  parents,  beginning  with  the  day  of  death.  The 
widow  and  each  child  up  to  the  age  of  15  receives  20  per  cent  of  the 
earnings  of  the  deceased,  though  the  sum  of  these  pensions  may  not 
exceed  60  per  cent  of  such  earnings. 

Premiums  paid  in  1904  were  $35,592,000;  disbursements,  $30,- 
552,000,  viz,  to  758,392  injured  members,  to  65,503  widows,  97,246 
children,  and  to  3,647  parents  of  those  killed. 

INVALID    AND   OLD-AGE   PENSIONS. 

Invalid  and  old-age  pensions  were  made  compulsory  under  the 
German  law  of  1889  (revised  in  1899)  for  all  wage-earners  with  an 
income  of  less  than  $480  per  annum ;  the  provisions  may  also  be  ex- 
tended to  include  petty  employers  and  persons  in  household  industry. 
The  invalid  pension  is  paid  without  regard  to  age  to  those  persons 
whose  earning  capacity  has  been  permanently  reduced  to  less  than 
one-third.  The  pension  is  also  paid  to  those  who  have  been  in  a  state 
of  disability  for  twenty-six  weeks  and  continues  as  long  as  the  disability 
lasts.  To  be  eligible  for  this  pension,  the  insured  person  must  have 
been  a  member  of  the  "  insurance  institute  "  for  two  hundred  weeks, 
during  which  time  not  less  than  100  payments  of  weekly  dues  must 
have  been  made.  If  the  disability  has  been  incurred  purposely 
the  right  to  a  pension  ceases  and  the  offender  is  liable  to  criminal 
prosecution. 


REPORTS   OP  THE  PRESIDENT'S  HOMES  COMMISSION.  97 

In  addition  to  the  pension  from  the  "  insurance  institutes "  the 
Empire  grants  a  stipend  of  50  marks  (about  $12)  per  annum  to 
invalids,  as  well  as  persons  over  70  years  of  age. 

Members  are  divided  into  five  classes  on  the  basis  of  wages  received. 
Each  class  pays  a  different  rate  of  dues  and  receives  benefits  in  pro- 
portion. The  lowest  invalidity  pension  granted  is  $27.70,  the  highest 
IS  $107.10  per  annum.  The  dues  range  from  3J  cents  per  week, 
according  to  the  wage  class  in  which  the  member  is  enrolled.  One- 
half  of  the  amount  is  paid  by  the  employer  and  one-half  by  the 
employee. 

The  old-age  pension  is  paid  without  regard  to  earning  capacity 
when  the  seventieth  year  of  age  is  completed.  Members  must  have 
paid  dues  for  one  thousand  two  hundred  weeks  before  they  become 
eligible  for  such  a  pension.  In  1904  there  were  40  inavlid  pension 
organizations,  with  13,800,000  insured  members.  Premiums  paid  in, 
$36,960,000 ;  disbursements,  $35,520,000.  The  average  invalid  pension 
is  $37.20,  and  the  old-age  pension  $37.68,  varying  in  amount  with  the 
wage  class. 

The  financial  soundness  of  the  system  is  secured  by  making  the 
employers,  the  guilds,  and  parishes  eventually  responsible  for  any 
deficit  in  the  various  sick  insurance  organizations.  The  national, 
state,  and  local  governments  guarantee  the  payment  of  claims  against 
the  accident  and  invalidity  insurance  organizations. 

SYNOPSIS   OF   PRACTICAL   RESULTS. 

The  financial  status  of  the  workingmen  has  been  improved  at  least 
to  the  extent  of  the  benefits  received  from  the  amounts  contributed  by 
the  employers  and  the  Government.  Experience  has  shown  that 
employers  have  not  deducted  their  share  of  the  dues  from  wages. 

The  hygienic  conditions  of  the  workingmen  have  been  improved, 
both  on  account  of  the  safeguards  which  the  accident  insurance  organ- 
izations require  employers  to  use  and  because  of  the  special  efforts 
made  by  the  "  sick  funds  "  to  reduce  the  sick  rate  among  the  members 
to  a  minimum.  The  general  knowledge  in  regard  to  the  preservation 
and  promotion  of  health,  which  the  "  sick  fund  organizations  "  have 
disseminated  by  means  of  circulars,  monographs,  popular  lectures, 
etc.,  have  exerted  a  tremendous  educational  influence  in  the  promotion 
of  health  and  morals.  One  of  the  most  beneficent  features  of  the 
entire  system  has  been  that  parts  of  the  funds  of  these  organizations 
are  invested  in  model  houses,  hospitals,  and  sanitoria  for  the  use  of 
members.  The  writer,  during  his  visit  to  Berlin  in  the  autumn  of 
1907,  had  occasion  to  inspect  some  of  these  workingmen's  houses,  as 
well  as  the  most  complete  and  elaborate  sanatorium  in  the  world,  at 
Beelitz,near  Berlin.  The  object  of  this  is  to  provide  the  very  best  facili- 
ties for  the  speedy  recovery  and  the  restoration  of  earning  power  of 
the  industrial  wage-earner.  Doctor  Bielefeldt  (Med.  Keform,  15th 
Jahrg,  1907,  p.  238)  calculates  that  in  the  treatment  of  159,802  tuber- 
culous patients  between  1897  and  1906  the  net  gain,  in  spite  of  an 
expenditure  of  56,000,000  marks,  amounted  to  more  than  4,500,000. 
It  is  interesting  to  note  that  the  Prussian  "  insurance  institutes  and 
sick  funds  "  in  1907  alone  maintained  28  hospitals  and  sanatoria,  the 
latter  chiefly  for  consumptives  and  convalescents.  One  of  the  latest 
features  was  the  establishment  in  1902  of  a  special  hospital  for  sexual 
diseases  in  the  male,  at  Lichtenberg,  near  Berlin,  and  a  sanitorium 
S.  Doc.  644.  60-2 8 


98 


REPORTS  OF  THE  PRESIDENT  S  HOMES  COMMISSION. 


for  nervous  and  anaemic  female  wage-earners  in  Pyrmont  (Hann- 
over) ;  all  upon  the  principle  that  it  is  in  the  highest  degree  good 
economy  to  restore  as  speedily  as  possible  the  unproductive  to  the 
ranks  of  the  producers.  Some  conception  of  the  good  work  may  be 
found  by  a  brief  description  of  the  sanatorium  at  Beelitz,  which  was 
erected  in  1902  by  the  "  insurance  institute "  of  Berlin  at  a  cost, 
according  to  report  of  directors,  June,  1907,  of  15,287,994  marks. 
Average  number  of  patients,  413  males  and  203  females;  number  of 
cases  treated  in  1906,  4,192 ;  number  of  hospital  days,  212,457 ;  expense 
for  1906,  1,470,062.25  marks,  or  at  the  rate  per  capita  per  day  of  6.92 
marks.  One  portion  of  the  institution  is  devoted  to  the  treatment  of 
incipient  cases  of  tuberculosis ;  another,  and  entirely  detached  depart- 
ment, to  cases  of  every  description  requiring  high-grade  sanatorium 
treatment  in  order  to  prevent  premature  invalidity.  Each  of  the 
handsome  and  spacious  pavilions  accommodates  200  males  or  100 
females ;  apart  from  these  are  4  porters'  lodges  for  the  4  departments 
under  separate  inclosures,  1  general  administration  building,  1  central 
power  and  heating  plant,  1  central  bathing  establishment,  1  disinfect- 
ing plant,  3  pumping  stations,  kitchen,  laundry,  workshops,  quarters 
for  medical  officers,  employees,  bowling  alleys,  hothouses,  stables,  etc. 
The  hospital  staff  consists  of  10  physicians  and  128  employees.       * 

The  writer  was  informed  in  September,  1907,  that  since  the  estab- 
lishment of  the  "  sick  funds  "  and  "  insurance  institutes  "  in  Germany, 
poverty  has  decreased  and  the  number  of  patients  treated  wholly  at 
public  expense  has  markedly  diminished,  as  workingmen,  even  of  the 
humbler  classes,  prefer  to  devote  their  sick  benefits  to  hospital  care, 
rather  than  be  a  charge  upon  the  parish  or  country. 

Income,  expenditures,  and  invested  funds  of  the  insurance  system. 


Item. 


Sick  insur- 
ance, 1901, 


Accident 

insurance, 

1902. 


Old-age  and 

invalidity 

insurance, 

1902. 


Total  of  all 
insurance, 
1835  to  1901. 


Dues  of  employers 

Dues  of  employees 

Subsidy  of  Imperial  Government. 
Interest  and  other  income 


.'  $13,952,723 
.1   31,126,584 


$29,907,868 


Totalincome. 


2,604,130 


3,743,936 


$16,539,308 
16,539,308 
9, 008, 227 
8,054,310 


$508, 445, 565 

487,147,059 

51,049,907 

93,588,044 


47, 683, 437 


33,651,804    60,141,153 


1,140,230,575 


Expenses  for  relief — 
Cost  of  administration 


Total  expenditures 
Inrested  funds 


43, 595, 450 
.|        2,590,837 


46, 186, 287 


44,421,557 


25, 735, 679 


29,701.662 
"4^^0^,235 


28, 658, 559 
2,843,541 


31,502,100         835,009,441 


239,779,652        309,020,248 


EFFECTS    OF    THE    INSURANCE    SYSTEM    ON    THE    EMPLOYER    AND    CONSUMEB. 

The  foregoing  table  shows  that  the  system  has  materially  added  to 
the  financial  burdens  of  the  employer,  but  it  is  believed  that  they  have 
not  been  too  heavy;  at  least  they  have  not  injured  Germany's  ability 
to  compete  in  forei^  markets. 

One  authority  estimates  that  the  amount  paid  by  the  employer  for 
accident  insurance  is  3  per  cent  of  the  wages,  for  sick  insurance  IJ 
per  cent  of  the  wages,  and  for  old-age  and  invalidity  insurance,  1  per 
cent,  or  a  total  of  5^  per  cent  of  the  wages  added  to  the  cost  of  pro- 
duction.    Doctor  Lass,  of  the  imperial  insurance  office,  concludes. 


REPORTS   OP   THE  PRESIDENT  S  HOMES   COMMISSION. 


99 


however,  that  this  burden  has  not  been  shifted  to  wages,  nor  has  it 
resulted  in  higher  prices  to  the  consumer,  but  has  been  made  up  by 
improved  methods  of  production. 

The  writer  has  purposely  devoted  much  space  to  the  German  in- 
dustrial insurance  system,  because  he  realizes  that  sickness  and 
funerals  are  the  most  potent  causes  of  poverty  and  distress ;  he  knows 
from  personal  knowledge  that  prior  to  1883  Germany  depended  upon 
employers'  liability  laws,  charitable  organizations,  and  private  com- 
panies for  the  protection  of  her  wage-earners,  with  very  questionable 
results.  While  much  has  been  achieved  in  other  directions  for  the 
prevention  of  disease,  the  most  distinct  gain  in  social-political  en- 
deavors was  made  by  the  enactment  of  these  laws,  and  especially  the 
law  of  June,  1889,  authorizing  "  insurance  institutes  "  to  invest  part 
of  their  funds  in  hospitals  and  sanatoria,  thus  affording  the  best  pos- 
sible facilities  for  the  speedy  recovery  and  the  prevention  as  far  as 
practicable  of  permanent  disabilities. 

According  to  Zacher  (Leitfaden  zur  Arbeiterversicherung  des 
Deutschen  Reiches,  1906) ,  quoted  by  Professor  Henderson,  "  at  the 
end  of  1905  in  all  70,000,000  pensioners  (sick,  injured,  invalids,  and 
their  dependents)  had  received  $1,200,000,000  in  benefits.  The  work- 
men have  contributed  less  than  one-half  of  the  premiums,  and  have 
received  $480,000,000  more  than  they  have  paid  out.  Property  is 
owned  to  the  amount  of  $408,000,000,  of  which  $120,000,000  have  been 
invested  in  w^orkmen's  dwellings,  hospitals,  and  convalescent  homes, 
sanatoria,  baths,  and  similar  institutions  of  welfare." 

There  is  no  pauperization  in  a  method  where  the  beneficiary  con- 
tributes such  a  large  share  to  the  undertaking.  As  a  matter  of  fact, 
methods  in  vogue  in  our  own  country  are  calculated  to  shift  all  of  the 
burden  upon  the  taxpayer. 

For  a  more  complete  exhibit,  the  following  tables  are  reproduced 
from  Professor  Henderson's  article  in  Charities,  December  7,  1907 : 

SICKNESS  INSURANCE    (SINCE   1885). 


Marks. 


United  States 
equivalent. 


Sickness  payments. 

Physicians 

Medicines,  etc 

.Hospitals 

Death  benefits 

Lying-in  women  . . . 
Various  benefits — 


1888-1904 
1905 


In  round  numbers 


,114,629,489 
514,803,920 
402,757,651 
303,061,148 
83, 763, 839 
36, 513, 672 
38,414,074 


2, 493, 973,  763 
250, 000,  COO 


2,744,000,000 


5267, 500, 077. 36 
123, 552, 940. 80 
96,661,836.24 
72, 734,  675. 52 
20,103,321.36 
8, 770, 481. 28 
9,219,377.76 


598, 553, 710. 32 
60,000,000.00 


658,  560, 000. 00 


ACCIDENT   INSURANCE 

(SINCE   ] 

18S5). 

759,172,928 
191,777,559 
34,275.716 
55,010.333 
6,927.990 
7, 747, 570 
2,846,489 

$182,201,502.72 

46,026,614.16 

8, 226. 171. 84 

13,202,479.92 

1,662,717.60 

1,859,416.80 

683,157.36 

Payments  to  dependents  of  deceased 

Medical  care 

Death  benefits                       

Widows                                                          

1885-1904         

1,057,758,586 
136, 000, 000 

253,862,060.40 
32,640,000.00 

1905 

In  round  numbers    

1,194, 000,  OCO 

286,560,000.00 

100  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

INVALID  AND  OLD-AGE   PENSIONS    (SINCE    1891). 


Marks. 


United  States 
equiyaleut. 


Invalid  pensions 

Old-nge  pensions 

Medical  care 

Return  of  premiums 

At  marriage 

At  death 

At  accident 

1891-1904 

1905 

In  round  numbers  . . 


560, 486, 961 

836,472,378 

55,371,747 

38,025,117 

13,422,508 

171,201 


$134,516,870.64 
80,753,370.72 
13,389,219.28 

9,126,028.08 

3,221,401.92 

41,088.24 


1, 003, 949. 912 
162, 000, 000 


240, 947, 878. 88 
38,880,000.00 


1,166,000,000 


279.840.000.00 


It  is  sincerely  hoped  that  the  wage-earners  of  this  country  may 
profit  by  the  experience  elsewhere  by  the  adoption  of  a  similar  system, 
and  thus  avoid  the  dangers  and  losses  to  which  they  are  now  so  fre- 
quently subjected  by  unscrupulously  managed  insurance  concerns. 

There  appears  to  be  no  good  reason  why  the  National  Government 
should  not  inaugurate  such  a  system  for  its  own  employees.  In  this 
connection  it  may  be  well  to  refer  to  a  most  successful  precedent  in 
the  establishment  of  the  United  States  Soldiers'  Home  in  Washington. 
This  institution  was  founded  in  1851  with  $100,000  paid  as  indemnity 
by  the  City  of  Mexico.  Every  soldier  is  taxed  at  the  rate  of  12J  cents 
per  month,  which  is  deducted  from  his  pay.  This  together  with  the 
fines  from  courts-martial  and  forfeited  pay  from  deserters  is  turned 
into  the  treasury  of  the  home.  The  home  now  owns  property  costing 
over  $2,500,000,  accommodates  950  inmates,  pays  a  commutation  at 
the  rate  of  $8  per  month  to  soldiers  having  dependents  and  unable  to 
avail  themselves  of  the  privileges  of  the  home,  amounting  to  about 
$20,000  a  year,  and  still  has  a  reserve  fund  of  about  $4,000,000. 


Chapter  XV. 

WHAT  THE  EMPLOYER  MAY  DO  FOR  THE  WELFARE  OF  EMPLOYEES. 

It  has  been  stated  at  the  outset  that  social  betterment  can  not  be 
disassociated  from  industrial  betterment,  and  it  is  here  that  the  em- 
ployer can  do  much  for  the  welfare  of  his  employees.  Apart  from  a" 
cheerful  compliance  with  the  laws  and  ordinances  which  may,  from 
time  to  time,  be  enacted  for  the  protection  of  the  working  classes,  it 
is  clearly  the  duty  of  the  employer  to  promote  in  every  way  the  effi- 
ciency and  earning  power  of  the  wage-earner  and  to  pay  such  wages 
as  are  necessary  to  improve  the  standard  of  living  among  poorly 
paid  employees. 

There  is  no  dojbt  that  thoughtful  employers  generally  realize  that 
they  are  not  only  responsible  for  the  proper  technical  training  of  ap- 
prentices, but  also  for  their  habits,  and  a  gratifying  number  of  estab- 
lishments have  made  every  effort  to  surround  them  with  all  possible 
chances  for  improvement,  mentally  and  morally.  There  is  a  class  of 
youthful  employees,  both  males  and  females,  for  whom  the  writer 
begs  to  enter  a  special  plea ;  they  are  entitled  to  every  consideration, 
because,  either  as  a  result  of  inheritance  or  faulty  environments,  they 


REPORTS   OP   THE  PRESIDENT'S  HOMES  COMMISSION.  101 

have  acquired  a  general  inaptitude;  they  are  perfectly  willing  to 
work,  but  awkward  in  all  their  movements — simply  do  not  know  how 
to  work — and  soon  exhaust  the  patience  of  their  instructors. 

Such  persons  are  found  seeking  to  make  an  honest  living  in  nearly 
all  occupations,  and  while  they  may  be  better  adapted  to  some  employ- 
ments than  others,  to  discharge  them  without  a  fair  trial  means  their 
utter  ruin.  Here  appears  to  be  a  field  for  human  sympathy,  and 
special  pains  should  be  taken  to  teach  them,  by  patient  fellow-work- 
men, how  to  handle  tools  and  work  to  better  advantage,  whether  it  is 
with  the  pick  or  shovel,  at  the  ploughshare,  the  street  or  house  broom, 
or  in  the  diversified  employments  of  artisans'  workshops. 

INDUSTRIAL  BETTERMENT. 

Space  will  not  permit  to  enter  into  details  concerning  efforts  which 
have  been  made  at  home  and  abroad  in  the  promotion  of  the  general 
welfare  of  the  working  classes.  At  a  meeting  of  the  American  Social 
Science  Association,  held  in  Washington,  April  18,  1901,  Mr.  J.  H. 
Patterson,  Dayton,  Ohio,  read  a  paper  on  factory  sanitation  and 
described  a  large  manufacturing  plant  of  which  he  is  the  head,  and 
their  close  adherence  to  the  principles  of  hygiene  and  the  uplifting  of 
mankind.  The  interior  of  the  factory  is  painted  in  cheerful  colors, 
extra  windows  were  made  to  give  light,  forced  ventilation  to  afford 
plenty  of  fresh  air,  and  all  dust  and  acid  fumes  are  carried  away  by 
exhaust  fans.  Bathrooms  and  well-furnished  toilet  rooms  are  on  all 
the  floors.  All  seats  have  backs.  Clean  aprons  are  furnished  by  the 
company,  and  a  dining  room  where  hot  meals  are  served  and  a  course 
in  domestic  economy  is  conducted.  The  grounds  around  the  factory 
and  the  houses  of  the  employees  are  healthful  and  attractive.  "  We 
have  demonstrated,"  said  Mr.  Patterson,  "  that  this  system  pays  the 
employee,  the  manufacturer,  and  the  buyer,  in  the  health  of  one, 
profit  of  the  second,  and  the  improved  quality  of  the  product  pur- 
chased by  the  third."  Bulletin  No.  31,  Department  of  Labor,  Novem- 
ber, 1900,  contains  an  article  on  betterment  of  industrial  conditions, 
showing  what  has  elsewhere  been  accomplished,  every  effort  being  in 
the  right  direction.  Among  the  most  important  may  be  mentioned 
(1)  the  increasing  of  industrial  efficiency  through  industrial  schools 
and  manual  training  classes;  (2)  the  care  for  employees'  health  and 
comfort  by  means  of  bathing  facilities,  gymnasiums,  calisthenics, 
baseball,  bicycle  clubs,  dining  and  lunch  rooms,  the  furnishing  of  hot 
lunches  free,  or  at  cost,  improved  sanitary  conditions  and  appliances ; 
(3)  the  improvement  of  domestic  conditions  by  means  of  improved 
dwellings,  instruction  in  sewing,  cooking  and  housekeeping,  in  land- 
scape and  kitchen  gardening,  and  the  exterior  and  interior  decora- 
tions of  homes;  (4)  the  care  of  sick  and  disabled  employees  and  their 
families  by  means  of  free  insurance,  medical  attendance  and  hospital 
facilities,  and  by  the  encouragement  of  beneficial  organizations; 
(5)  club  organizations  for  social,  recreative,  and  intellectual  purposes 
by  means  of  free  lectures,  libraries,  kindergartens  and  educational 
classes,  social  gatherings,  summer  outings,  meeting  places,  game 
rooms,  banquets,  dances,  etc.;  (6)  the  encouragement  of  musical  and 
dramatic  clubs  and  the  promotion  of  spiritual  life  by  means  of  Sun- 
day schools  and  general  religious  work;  (7)  the  cultivation  of  thrift 


102  REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

through  savings-bank  facilities,  building  associations,  or  provident 
organizations,  rewards  for  valuable  suggestions  of  employees,  for 
faithful  service  or  the  manifestation  of  zeal  and  interest  in  their 
employment;  (8)  the  promotion  of  employees'  personal  interest  in  the 
successful  co^iduct  of  the  business  by  encouraging  and  assisting  them 
to  purchase  shares,  financial  aid  to  employees  in  case  of  unusual  hard- 
ships and  distress,  and  the  cultivation  of  cordial  and  even  confidential 
relations  between  employer  and  employees.  (For  details  consult  Bul- 
letin of  the  Department^of  Labor  No.  31,  pp.  1117-1156.) 

It  is  gratifying  to  note  that,  although  Washington  is  not  an  indus- 
trial center,  a  large  number  of  firms  have  taken  steps  for  the  promo- 
tion of  the  general  welfare  of  employees. 


Chapter  XVI. 

WHAT  THE  GENERAL  PUBLIC  MAY  DO. 

There  is  a  tendency  at  present  among  young  men,  the  sons  of  par- 
ents who  have  accumulated  some  means,  to  expect  to  live  and  grow 
rich  w^ithout  manual  labor.  It  is  becoming  fashionable  to  look  upon 
the  mechanic  with  disdain,  to  consider  manual  labor  degrading,  an 
evidence  of  low  breeding,  and  all  such  nonsense.  The  young  men 
want  to  be  bookkeepers,  bankers,  lawyers,  doctors,  or  office  holders, 
anything  which  does  not  involve  manual  labor,  and  expect  their 
fathers  to  furnish  the  means  to-  attain  the  goal  of  their  ambition ;  as 
a  result  the  professions  are  overcrowded  and  men  fail  who  might 
have  been  successful  in  the  handicrafts.  Let  us  teach  our  children 
to  respect  and  perform  honest  labor,  whether  it  is  behind  the  plow- 
share, in  the  saddle,  or  in  the  workshops.  It  will  teach  them  self- 
reliance,  prudence,  and  perseverence. 

It  will  be  conceded  that  the  burdens  of  improving  industrial  and 
social  conditions  should  not  be  carried  by  the  employer  and  employees 
alone.  There  are  many  phases  of  vital  importance  from  the  stand- 
point of  public  health  and  humanity  which  should  concern  every 
thoughtful  man  and  woman.  Reference  has  already  been  made  to 
the  appalling  and  dangerous  conditions  under  which  many  of  the 
trades  and  occupations  are  carried  on  in  tenement  houses.  While 
this  is,  in  part,  due  to  the  greed  of  the  manufacturer,  because  it  means 
less  factory  space,  less  rent,  light,  fuel,  and  a  decidedly  smaller  pay 
roll,  the  consumer  is  equally  to  blame,  because  of  his  constant  demand 
for  cheaper  goods,  quite  oblivious  to  the  fact  that  the  garments  may 
be  a  source  of  danger  from  infectious  diseases,  and  are  stained  with 
the  sweat  and  blood  of  helpless  women  and  little  children. 

During  one  of  the  presidential  campaigns  a  clever  orator  referred 
to  Glasgow,  and  told  us  that  41,000  of  the  100,000  laboring  families 
of  that  manufacturing  center  lived  in  1-room  tenements,  and  that  this 
one  room  for  a  family  of  father,  mother,  daughters,  and  sons  told 
what  the  wages  in  Scotland  were  and  how  they  dragged  humanity 
down  into  bestiality  and  misery.  We  need  not  go  to  Glasgow  for 
such  illustrations,  for  to  our  shame  it  must  be  confessed  that  similar 
conditions  obtain  in  nearly  every  American  industrial  city.  The 
effects  of  such  conditions  upon  death  rates  will  be  presently  referred 
to.     In  the  meantime,  it  will  be  readily  conceded  tnat  the  people  do 


BEPORTS   OF   THE  PBESIDENT^S  HOMES  COMMISSION.  103 

not  live  as  a  rule  in  such  quarters  from  choice,  but  from  sheer  neces- 
sity. Low  wages  compel  the  working  classes  not  only  to  find  shelter 
in  houses  unfit  for  human  occupation,  but  also  affect  their  health 
and  the  health  of  their  children  by  insufficient  food  and  clothing,  and 
last,  but  not  least,  it  means  the  utilization  of  child  and  female  labor 
in  some  of  the  most  atrocious  forms  referred  to  on  another  page. 
Indeed,  there  is  much  reason  for  assuming  that  low  standards  of  liv- 
ing, which  insufficient  wages  tend  to  beget,  play  a  very  important  role 
in  physical,  mental,  and  moral  degeneracy.  "  Physical  health  is  the 
basis  of  mental  health."  This  aphorism  of  Aristotle  has  been  proved 
to  be  true  by  the  experience  of  every  educator. 

Professor  Dawson,  in  his  study  of  youthful  degeneracy  (Pedagog- 
ical Seminary,  Vol.  IV,  p.  2),  found  among  the  boys  and  girls  m 
reform  schools  evidence  of  physical  degeneracy  as  shown  by  lighter 
weights,  shorter  statures,  and  diminished  muscular  power,  and  de- 
clared that  16  per  cent  of  those  examined  by  him  were  "  clearly  suf- 
ferers from  low  nutrition."  It  is  to  be  hoped  that  the  public  con- 
science may  be  sufficiently  aroused  to  insist  upon  adequate  wages  for 
all  classes,  and  that  the  producer  and  consumer  alike  will  be  willing 
to  assume  this  responsibility,  not  as  a  matter  of  charity,  but  in  justice 
to  the  laboring  classes. 

In  the  whole  range  of  social  betterment  and  sanitation,  especially 
in  our  efforts  to  combat  tuberculosis,  no  field  affords  better  oppor- 
tunity for  philanthropic  work  than  the  erection  of  sanitary  homes  for 
wage-earners,  at  reasonable  rentals,  the  encouragement  of  cooking 
schools,  and  the  establishment  of  model  lodging  and  eating  houses. 
The  new  York  City  and  Suburban  Homes  Company  has  now  for  divi- 
dend disbursements  4.5  per  cent  a  year  on  an  investment  of  $5,500,000. 
The  Washington  Housing  Companies  have  an  investment  of  over  one 
million,  have  paid,  respectively,  4  and  5  per  cent  from  the  very  incep- 
tion of  the  companies,  and  have  a  surplus  fund  of  over  $100,000. 
London  has  more  than  $100,000,000  invested  in  model  tenements. 

HOUSES  FOR  WAGE-EARNERS. 

The  housing  of  the  working  classes  has  very  properly  been  made 
the  subject  of  legislation  in  many  countries,  and  is  a  matter  in  which 
factory  owners,  labor  unions,  and  the  general  public  should  be  deeply 
and  mutually  interested.  There  are  several  systems  of  dwellings 
for  artisans  and  laborers,  viz,  individual  houses  or  cottages,  a  row 
of  houses  under  one  roof,  and  the  so-called  "  flats."  Preference 
should  be  given,  when  practicable,  to  the  cottage  system,  but  in  large 
cities  unfortunately  the  value  of  real  estate  frequently  compels  the 
erection  of  large  tenements,  and  in  such  an  event  the  State  should 
insist  upon  hygienic  requirements  as  regards  air  space,  light,  and 
ventilation.  No  home  can  be  considered  sanitary  where  one  room  has 
to  answer  the  purposes  of  a  living  room,  sleeping  room,  and  kitchen 
or  where  the  water-closet  or  privy  is  used  by  more  than  one  family. 

EVIL  EFFECTS  OF  INSANITARY  HOUSES  AND  OVERCROWDING. 

The  primary  object  of  habitations  is  to  secure  protection  from  the 
influence  of  heat,  cold,  rain,  sunshine,  and  storms,  and  thus  promote 
the  health  and  happiness  and  indirectly  also  the  morals  and  culture 
of  the  human  race. 


104  REPORTS  OP   THE  PRESIDENT'S  HOMES  COMMISSION. 

The  intluence  of  sanitary  houses  can  not  be  overestimated.  Doctor 
Villernie,  in  an  investigation  in  France  from  1821  to  1827,  found  that 
among  the  inhabitants  of  arrondissements  containing  7  per  cent  of 
badly  constructed  dwellings,  1  person  out  of  every  72  died ;  of  inhabit- 
ants of  arrondissements  containing  22  per  cent  of  badly  constructed 
dwellings,  1  out  of  65  died,  while  of  the  inhabitants  of  arrondisse- 
ments containing  38  per  cent  of  badly  constructed  dwellings,  1  out 
of  every  15  died. 

With  the  present  rapid  transit  facilities  in  every  city,  our  voice 
should  be  clearly  in  favor  of  individual  homes ;  and  when  this  is  im- 
practicable, we  should  insist  on  broad  streets  and  deep  yards.  No 
more  than  68  per  cent  of  the  lot  should  be  covered  by  the  house,  and 
the  height  of  the  building  should  never  exceed  the  width  of  the  street. 
The  baneful  effects  of  tenement  houses  should  be  avoided,  as  infec- 
tious diseases  are  more  liable  to  spread  in  consequence  of  aerial  infec- 
tion and  the  more  intimate  contact  of  the  occupants. 

Apart  from  structural  defects,  there  is  no  doubt  that  the  death 
rate  is  largely  determined  by  the  number  of  occupants  to  a  room. 
Russell  has  shown  that  in  Glasgow,  when  the  average  number  of  per- 
sons to  each  room  was  only  1.31,  the  mortality  was  21.7  per  1,000,  and 
when  the  number  of  occupants  amounted  to  2.05  for  each  room,  the 
mortality  reached  28.6  per  1,000. 

According  to  Korosi,  the  mortality  from  infectious  diseases  at 
Budapest  is  only  20  when  the  number  of  occupants  to  each  room  does 
not  exceed  2,  but  is  29  per  1,000  with  3.5  occupants,  32  per  1,000  with 
6.10  occupants,  and  79  per  1,000  when  there  are  more  than  10  occu- 
pants to  each  apartment. 

TJae  death  rate  at  Berlin,  in  1885,  among  the  73,000  one-room  ten- 
ements was  163.5  per  1,000,  against  5.4  per  1,000  among  398,000  resi- 
dents occupying  four  or  more  room  apartments.**  The  analysis  of  2,701 
infantile  deaths  in  Berlin  during  1903,  investigated  by  Neumann,  has 
been  presented  elsewhere  in  this  work. 

Insanitary  dwellings  are  to  be  found  everywhere,  and  particularly 
in  older  cities,  erected  at  a  time  when  the  principles  of  sanitation  were 
comparatively  unknown.  One  of  the  most  important  municipal 
problems  is  to  correct  existing  evils  by  the  enactment  and  enforce- 
ment of  suitable  laws.  It  requires,  however,  a  strong  public  senti- 
ment to  bring  about  a  complete  and  satisfactory  reformation,  as  evi- 
denced by  the  housing  movement  elsewhere,  for  in  spite  of  the  excel- 
lent tenement-house  laws  in  New  York,  according  to  Homer  Folks, 
of  370,000  dark  rooms  reported  in  existence  by  the  De  Forest  tene- 
ment-house department  in  1903,  some  20,000  only  have  been  opened 
to  the  light  during  the  past  three  and  a  half  years.  The  prohibition 
against  the  use  of  cellar  and  basement  rooms  partly  underground 
can  not  be  enforced,  owing  to  the  lack  of  a  sufficient  number  of  in- 
spectors. The  notorious  Lung  Block  "  continues  to  contribute  its 
horrifying  quota  to  the  annual  mortality.  (Charities,  November  30, 
1907.) 

The  writer  has  no  hesitation  in  declaring  that  the  housing  condi- 
tions of  the  least  resourceful  of  people  have  been,  and  are  even  now, 
more  potent  than  any  other  factor  in  helping  to  swell  the  frightful 

•Town  and  City,  Jewett,  p.  14. 


BEPOBTS   OP   THE  PRESIDENT'S  HOMES   COMMISSION.  105 

mortality  from  consumption  and  other  so-called  house  diseases  en- 
gendered by  unwholesome  environment. 

HOUSE   DISEASES. 

It  has  long  been  known  that  rickets,  scrofula,  and  other  chronic 
forms  of  tuberculosis  are  especially  prevalent  in  dark,  damp,  and 
insanitary  houses.  The  children  are  anaemic  and  as  puny  as  plants 
reared  without  the  stimulating  effects  of  sunlight.  Add  to  this  the 
fact  that  dampness  abstracts  an  undue  amount  of  animal  heat,  lowers 
the  power  of  resistance,  and  favors  the  development  of  catarrhal  con- 
ditions, which  render  the  system  more  vulnerable  to  tuberculosis,  and 
we  have  a  reasonable  explanation  why  these  diseases  prevail,  espe- 
cially in  basements  or  houses  below  grade  and  otherwise  unfit  for 
human  habitation.  The  death  rate  is  often  double  and  treble  that 
of  other  localities,  and  while  there  are  doubtless  other  factors  which 
determine  the  frightful  mortality,  none  are  more  potent  than  deficient 
sunlight  and  ventilation.  Diphtheria,  cerebro-spinal  meningitis, 
acute  and  chronic  rheumatism,  and  bronchial  affections  are  also  more 
frequent  in  insanitary  dwellings. 

That  the  same  is  true  of  infantile  diarrhea  is  doubtless  due  to  the 
fact  that  the  construction  of  the  buildings  does  not  protect  from  the 
heat  of  summer,  and  the  enervating  effects  of  heat  and  the  more 
speedy  decomposition  of  food  (especially  of  milk)  in  such  an  atmos- 
phere, combine  to  carry  on  the  slaughter  of  the  innocents. 

The  existence  of  disease-breeding  habitations  is  a  reflection  upon 
Christian  civilization,  and  there  should  be  sufficient  human  sympa- 
thy to  provide  decent,  healthful  homes  for  our  wage-earners,  who 
constitute,  after  all,  the  bone  and  sinew  of  the  country;  and  this  is 
one  of  the  occasions  when  we  may  well  act  as  our  brother's  keeper. 

The  history  of  improved  dwellings  reveals  everywhere  a  lessened 
death  rate,  and  the  experience  of  the  Washington  Sanitary  Improve- 
ment Company  is  equally  gratifying.  During  the  year  ending  De- 
cember 31,  1906,  the  apartments  were  occupied  by  778  adults  and  380 
children,  total,  1,158;  births,  39  and  only  16  deaths,  10  adults  and  6 
infants,  a  death  rate  of  about  13.7  per  1,000 — which,  with  all  due 
allowance  for  the  average  age  of  the  occupants,  shows  a  remarkbly 
low  mortality  when  compared  with  the  general  death  rate  among  the 
white  population  of  15.16  per  1,000. 

This  regeneration  of  the  housing  conditions  for  the  least  resource- 
ful people  is  the  great  sanitary  and  social  problem  of  the  twentieth 
century. 

Take  away  the  hovels  and  filthy  places,  let  sunshine  and  pure  air 
circulate  through  their  homes,  and  teach  them  habits  of  cleanliness 
and  responsibility,  and  the  first  step  toward  the  elevation  of  the  de- 
graded and  the  education  of  the  ignorant  will  be  taken,  not  only  in 
the  warfare  against  tuberculosis  and  other  diseases  engendered  by 
insanitary  surroundings,  but  also  in  the  battle  for  higher  moral  and 
social  standards. 

LODGING  HOUSES  OR  HOMES  FOR  WAGE-EARNERS. 

Those  who  have  read  "  The  Long  Day  "  can  not  fail  to  be  im- 
pressed with  the  just  criticism  of  our  present  system  of  homes  for 


106  REPORTS  OF   THE  PRESIDENT'S   HOMES  COMMISSION. 

working  girls.  The  author  makes  a  strong  plea  for  homes  designed 
after  the  Mills  hotels  for  workingmen ;  no  charity,  but  so  built  and  con- 
ducted that  they  will  pay  a  4  per  cent  rate  of  interest  upon  the  money 
invested.  "A  clean  room  and  three  wholesomely  cooked  meals  a  day 
can  be  furnished  to  working  girls  at  a  price  such  as  would  make  it 
possible  for  them  to  live  honestly  on  the  small  wages  of  the  factory 
or  store.  We  do  not  ask  for  luxuries  or  dainties.  In  the  model  lodg- 
ing house  there  should  be  perfect  liberty  of  conduct  and  action  on  the 
part  of  the  guests,  who  w411  not  be  '  inmates '  in  any  sense  of  the 
word  so  long  as  the  conventions  of  ordinary  social  life  are  complied 
with." 

It  is  to  be  hoped  that  her  simple  but  truthful  story  will  be  read 
and  her  appeal  for  industrial  and  social  betterment  answered.  So 
long  as  the  conditions  described  in  the  book  exist,  so  long  will  it  be 
wicked  to  rear  magnificent  and  costly  church  edifices,  and  in  this 
respect  Christian  civilization,  which  should  be  a  strong  factor  in 
uplifting  and  regenerative  influences,  has  been  remiss  in  its  sacred 
obligations.  To  supply  the  needs  spoken  of,  together  with  the  estab- 
lishment of  cooking  schools  and  kindergartens  so  that  the  children  of 
toil  may  at  least  have  an  opportunity  to  learn  to  work  intelligently, 
may  be  regarded  as  a  suitable  field  for  practical  Christianity,  and' 
would  do  much  toward  narrowing  the  breach  which  now  exists  be- 
tween the  church  and  wage-earners  and  between  capital  and  labor. 

FOOD   FOR   WORKING   CLASSES. 

While  the  character  and  variety  of  food  now  served  is  very  much 
better  than  it  was  fifty  years  ago,  it  is  not  what  it  should  be,  espe- 
cially in  lodging  houses.  The  chief  faults  consist  in  improper  cooking 
and  the  widespread  error  of  consuming  a  cold  dinner  from  the  lunch 
basket  or  dinner  bucket. 

The  art  of  cooking  and  how  to  supply  good  wholesome  food  and  in 
proper  quantities  should  be  made  the  subject  of  popular  instruction. 
The  "  Ladies  Sanitary  Association  of  England  "  deserves  credit  for 
having  taken  this  matter  in  hand,  especially  since  experience  teaches 
that  nothing  prevents  the  abuse  of  alcohol  so  much  as  a  sufficient  and 
palatable  supply  of  food. 

The  establishment  of  public  kitchens  and  eating  houses  for  un- 
married laborers  conducted  upon  practical  sanitary  and  economic 
principles  would  prove  a  great  blessing;  the  same  may  be  said  of 
lunch  rooms  where  rolls,  sandwiches,  a  cup  of  coffee,  tea,  milk,  hot 
soups,  etc.,  may  be  obtained  at  a  nominal  cost,  and  which  would 
materially  lessen  the  evils  of  intemperance. 

Since  coffee  and  tea  allay  thirst  and  are  stimulants,  without  the 
depressing  effects  of  alcoholics,  there  is  no  reason  why  factories  and 
workshops  should  not  supply  these  beverages  at  noon  to  employees 
at  actual  cost.  The  subject  of  food  and  cooking  will  be  discussed  in 
a  special  paper. 


REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  107 


Chapter  XVII. 

WHAT    THE    EMPLOYEE    MAY    DO    TO    CONTRIBUTE    TO    HIS    OWN 

WELFARE. 

Sufficient  has  been  said  in  the  preceding  pages  to  indicate  the 
dangers  to  which  the  working  classes  are  exposed  in  many  industrial 
pursuits,  and  the  methods  proposed  to  alleviate  the  effects  have  also 
been  pointed  out.  It  must  be  6onceded  that  all  remedial  efforts  have 
been  prompted  by  the  true  spirit  of  humanity  and  as  a  social  duty; 
hence  it  is  reasonable  to  expect  that  wage-earners  should  show  a 
willingness  to  avail  themselves  of  the  various  "  safety  devices  "  and 
not  underrate  their  importance  in  the  protection  of  life  and  limb. 
While  it  is  criminal  for  employers  not  to  provide  suitable  protection, 
it  is  equally  culpable  on  the  part  of  the  operatives  to  disregard  all 
such  preventive  measures.  So,  for  example,  it  is  not  a  pleasing  reflec- 
tion to  be  told  by  Doctor  Harrington,  professor  of  hygiene  at  the 
Harvard  Medical  School,  in  speaking  of  respirators,  that  "Aside 
from  the  discomfort  caused,  the  operatives  have  another  and  a  sense- 
less objection  to  their  use;  women  complaining  that  they  are  made 
to  look  ridiculous,  and  men  being  moved  to  discard  them  by  the 
gibes  of  their  more  reckless  fellows."  In  January,  1908,  the  writer 
visited  Frankford  Arsenal  and  found  men  working  in  high  explo- 
sives without  rubber  gloves  and  respirators,  although  provided  by 
the  Government.  (See  p.  60).  Doctor  Farrand,  Secretary  of  the 
National  Association  for  the  Study  and  Prevention  of  Tuberculosis, 
also  spoke  to  me  of  the  great  difficulties  he  and  others  have  encoun- 
tered in  New  York  and  New  Jersey  in  inducing  the  operatives  to 
give  safety  devices  a  fair  trial. 


PART  II.-  SOCIAL  BETTERMENT. 


Chapter  I. 

HOW  VO  KEEP  WELL  AND  CAPACITATED  FOR  WORK. 

It  is  a  matter  of  constant  observation  that  families,  even  with  a 
modest  income,  get  along  very  well  until  sickness  and  death  enters  the 
once  happy  home;  and  if  these  financial  burdens  and  sorrow  can  be 
prevented  it  is  clearly  our  duty  to  do  so,  even  if  the  "  chief  bread 
winner  "  is  not  himself  incapacitated  for  work.  For  these  reasons 
the  writer  offers  a  few  suggestions  along  the  lines  of  general  and 
personal  hygiene,  with  the  hope  that  they  may  serve  to  diminish 
human  suffering  and  distress.  In  doing  so,  while  utilizing  his  own 
lecture  material,  he  is  indebted  for  the  inspiration  and  popular  pres- 
entation, as  well  as  some  of  the  subject-matter,  to  the  valuable 
brochure  by  Prof.  Fritz  Kalle  and  Dr.  Gustav  Schellenberg  "  Wie 
erhalt  man  sich  gesund  und  erwerbsf  ahig,  Berlin,  1907." 

HOUSE   AND   HOME. 

Special  pains  should  be  taken  in  the  selection  of  living  quarters, 
no  matter  how  humble  they  may  be,  as  they  constitute  our  abode  for 
the  greater  part  of  our  life.  With  the  excellent  motor  facilities,  there 
is  no  reason  why  crowded  tenements  should  be  chosen,  and  prefer- 
ence should  always  be  given  to  individual  homes,  or  apartments,  in 
not  exceeding  two-story  tenements.  The  Germans  have  an  old  but 
true  proverb :  "  Where  the  sun  does  not  enter  the  doctor  surely  will ;" 
hence  dark,  gloomy  and  damp  houses  should  be  avoided;  moldy 
spots  on  the  walls  or  ceilings  and  a  close  musty  odor  indicate  damp- 
ness, and  cheap  rents  should  prove  no  inducement  to  occupy  such 
quarters.  Leaky  roofs  and  down  spouts,  or  a  pile  of  ashes  against 
a  brick  wall,  may  keep  the  house  damp,  and  the  causes  should  be 
promptly  removed.  In  all  such  instances,  as  well  as  in  the  occupancy 
of  a  recently  constructed  house,  it  is  very  desirable  to  dry  out  the 
house  by  heat  and  open  windows. 

Since  we  know  that  the  mortality  from  contagious  diseases  in- 
creases in  proportion  to  the  number  of  inmates  of  the  rooms,  hygiene 
requires  that  even  the  most  modest  dwellings  should  afford  sufficient 
room  to  prevent  overcrowding.  Ventilation  is  always  necessary,  but 
open  windows  are  especially  indicated  at  night,  as  nothing  can  take 
the  place  of  pure  fresh  air  in  small  quarters.  This  may  be  effectively 
accomplished  without  the  danger  of  drafts  by  opening  the  window 
in  the  bedrooms  from  the  top,  and  those  of  the  adjoining  room  at  the 
bottom.  Night  air,  contrary  to  popular  opinion,  is  not  unwholesome. 
The  only  danger  is  from  mosquitoes,  which  should  be  excluded  by 
proper  screening  of  windows  and  doors. 

109 


110  REPORTS  OF  THE  PRESIDENT'S  HOMES  COMMISSION. 

There  are  many  families  who  properly  insist  upon  having  a  sit- 
ting room  or  parlor,  which  is  most  commendable,  if  the  bedrooms  are 
large  enough  to  afford  500  cubic  feet  of  air  space  for  each  occupant. 
If  they  do  not,  it  is  desirable  after  proper  airing  of  the  larger  rooms 
to  utilize  them  for  sleeping  purposes,  for  it  must  be  remembered  that 
the  air  of  habitations  is  vitiated  by  the  consumption  of  oxygen  and 
the  exhalation  of  carbonic  acid.  The  airing  of  rooms  is  even  more 
essential  in  cold  weather,  because  of  the  additional  pollution  by 
carbonic  acid  from  light  and  fires.  There  are  a  number  of  families, 
unfortunately,  who  for  various  reasons  are  obliged  to  live,  cook,  and 
sleep  in  one  room,  and  for  whom  the  question  of  fresh  air  is  therefore 
of  vital  importance.  Such  families  should  not  hesitate  to  avail  them- 
selves of  the  benefit  of  fresh  air,  especially  when  medical  science  has 
demonstrated  the  advantages  of  fresh  and  even  cold  air  in  the  treat- 
ment of  consumption  and  pneumonia,  provided  the  body  is  kept 
warm  by  sufficient  bedclothes. 

The  household  dust  is  as  objectionable  in  many  respects  as  the  dust 
of  workshops,  because  dust  and  germs  always  go  hand  in  hand.  So, 
for  example,  Uffelmann  found  that  while  the  outer  air  contained  only 
250  ^erms  in  10  cubic  feet  the  air  of  his  library  contained  2,900,  of 
his  sitting  room  7,500,  of  his  bedroom  12,500  and  the  air  of  a  living 
room  of  a  workingman's  family  as  many  as  31,000  germs.  He  also 
demonstrated  that  they  increased  after  disturbing  the  dust  of  the 
rooms  by  feather  dusters  or  by  slamming  the  doors,  showing  that  they 
actually  cling  to  the  household  dust.  If  the  dust  should  happen  to 
contain  the  germs  of  tuberculosis,  from  carelessly  expectorated  spu- 
tum, or  which  may  have  been  carried  into  the  house  upon  the  soles  of 
footwear,  bottom  of  skirts,  etc.,  such  dust  may  prove  a  source  of 
danger,  especially  to  children. 

HOUSE   CLEANING. 

For  reasons  just  given,  there  should  be  no  accumulation  of  dust  in 
any  part  of  the  premises.  Hygiene,  therefore  condemns  all  carpets 
and  interior  finishes  which  serve  as  dust  and  germ  traps,  such  as 
heavy  cornices,  elaborate  moldings  of  door  and  window  frames, 
wardrobes,  cumbersome  draperies,  and  unnecessary  furniture.  Hy- 
giene, on  the  other  hand,  approves  of  neatly  polished  floors  with 
small  rugs,  which  can  be  easily  taken  up  and  cleaned  outside  of  the 
house,  curves  instead  of  cornices  and  angles,  smooth  and  nonabsorbent 
walls,  instead  of  embossed  wall  papers,  simplicity  of  furniture,  closets 
instead  of  bureaus  and  wardrobes.  In  brief,  everything  which 
will  prevent  the  collection  of  dust  and  germs  and  facilitate  their 
removal  may  be  regarded  as  hygienic.  So,  for  example,  a  plain, 
tinted,  smooth  wall,  or  the  varnished  wall  papers,  which  can  be 
cleaned  with  a  damp  cloth,  or  any  smooth  wall  paper  guaranteed  to 
be  free  from  arsenic,  are  in  point  of  health  superior  to  the  embossed 
silk  hangings  and  tapestries  of  the  rich  man's  home. 

The  object  of  house  cleaning  is  primarily  to  get  rid  of  the  dust 
and  germs.  In  sweeping  it  is  desirable,  therefore,  to  open  the  upper 
windows,  but  to  keep  the  door  leading  into  the  hall  closed,  so  that  the 
dust  may  not  be  wafted  back  into  the  house.  The  dusting  should 
always  be  done  with  a  soft,  damp  cloth,  frequently  changed.     Under 


REPORTS   OP   THE  PRESIDENT'S  HOMES   COMMISSION.  Ill 

no  circumstances  should  the  feather  duster  be  used  inside  of  the  house, 
as  it  does  not  remove,  but  simply  displaces  the  dust.  If  the  cracks  in 
floors  have  been  neatly  filled  up,  and  the  floors  oiled  or  waxed,  they 
can  be  cleaned  with  a  damp  cloth  much  more  effectively  than  by  the 
tiresome  process  of  scrubbing,  a  drudgery  to  every  neat  housekeeper. 
The  kitchen,  cooking,  and  eating  utensils  need  special  care,  as  un- 
clean food  and  utensils  are  often  the  cause  of  cholera-morbus  and 
diarrheal  diseases.  Captain  Sanderson,  in  the  Cook's  Creed,  pub- 
lished for  the  United  States  Army,  in  1862,  showed  his  sanitary  acu- 
men when  he  said : 

Better  wear  out  your  pans  with  scouring  than  your  stomachs  with  purging, 
and  it  is  less  dangerous  to  worli  your  elbows  than  your  comrades'  bowels. 
Dirt  and  grease  betray  the  poor  cook  and  destroy  the  poor  soldier. 

Every  effort  should  be  made  to  have  clean  and  cool  storage  facilities 
for  food,  and  all  perishable  food,  especially  milk  for  infant  feeding, 
should  be  kept  on  ice  whenever  the  temperature  is  above  60°, 

TEMPERATURE. 

The  most  healthful  room  temperature  in  cold  weather  is  between 
65°  and  70°,  as  overheated  rooms  predispose  to  colds  and  should  be 
avoided. 

When  the  house  or  apartment  is  heated  by  cast-iron  stoves  or  other 
heaters,  special  care  is  necessary  not  to  bring  them  to  a  red  heat,  as 
the  very  dangerous  coal  gas  is  liable  to  escape  through  invisible  fis- 
sures in  the  plate  and  joints  while  the  heaters  are  red  hot.  It  is 
desirable  to  select  a  good-sized  heater  lined  with  fire  clay,  which  will 
not  have  to  be  brought  to  a  red  heat,  and  at  the  same  time  furnishes 
sufficient  volume  of  warm  air.  If  the  air  is  superheated  it  acquires 
a  peculiar  odor,  probably  due  to  charring  of  organic  dust;  it  also 
becomes  very  dry  and  irritating,  owing  to  the  rapid  evaporation  of 
moisture  from  the  skin  and  mucous  surfaces  of  the  inmates,  and  in 
consequence  is  apt  to  produce  catarrhal  affections,  conditions  which  do 
not  prevail  when  care  is  taken  and  provisions  made  for  the  evapora- 
tion of  a  certain  amount  of  water.  Coal  oil  or  gas  stoves  can  not  be 
recommended,  unless  provisions  are  made  to  carry  off  the  products  of 
combustion. 

The  danger  from  fire,  which  is  always  a  great  calamity,  should  be 
reduced  to  a  minimum  by  preventing  the  accumulation  of  combustible 
material  on  the  premises,  proper  care  of  matches,  and  instruction  of 
the  children.  Coal  oil,  gasoline,  etc.,  should  never  be  used  for  kin- 
dling purposes ;  there  is  always  great  danger  from  explosions,  fire,  and 
fatal  burns  by  filling  a  burning  lamp,  or  extinguishing  the  wick  by 
blowing  over  the  chimney,  or  using  a  lamp  when  the  chimney  is 
broken. 

INSECTS. 

Special  attention  should  be  paid  to  the  exclusion  and  destruction 
of  house  flies,  mosquitoes,  and  other  insects,  for  apart  from  the  dis- 
comfort produced,  there  is  much  reason  ^or  assuming  that  disease 
germs  may  be  conveyed  by  flies  and  mosquitoes,  fleas,  bedbugs,  and 
roaches.     Celli,°  of  Rome,  in  1888,  demonstrated  that  the  germs  of 

«A.  Celli  Boll.  dell.  Soc.  Lancis,  degli,  ospedali  di  Roma,  1888. 


112  REPORTS   OP   THE  PRESIDENT'S  HOMES  COMMISSION". 

tuberculosis  and  other  disease  germs  may  retain  their  vitality  after 
passing  through  the  intestinal  tract  of  flies.  Spillmann  ^  pointed  out 
that  flies  caught  while  feeding  upon  the  expectoration  of  a  consump- 
tive invariably  contained  viable  germs,  and  Hoffmann  *  not  only  con- 
firmed these  observations,  but  also  found  the  germs  in  the  fly  spots 
on  the  walls  of  a  room  occupied  by  a  phthisical  subject.  The*^  writer 
has  declared  it  his  opinion  for  years  that  flies  may  carry  the  germs 
on  their  feet,  from  typhoid  stools  and  infected  sources,  to  the  food 
and  milk  supply,  and  in  1895  ^  pointed  out  a  number  of  house  infec- 
tions in  this  city  which  could  not  be  explained  in  any  other  way.  The 
experience  of  the  Spanish-American  war  appears  to  have  fully  con- 
firmed this  conclusion.  In  like  manner,  the  germs  of  cholera  and  of 
the  oriental  pest  have  been  disseminated  by  the  house  fly. 

Professor  Stiles,  of  the  Public  Health  and  Marine-Hospital  Service, 
has  shown  that  the  eggs  of  the  pork  worm,  whip  worm,  pin  worm, 
and  round  worm  may  be  carried  by  flies  to  the  food  and  there  is  rea- 
son to  believe  that  purulent  affections  of  the  eye  and  wound  infections 
may  be  thus  conveyed. 

The  evidence  that  certain  species  of  mosquitoes  are  the  intermedi- 
ate host  of  the  germs  of  malaria  and  yellow  fever,  and  that  man  may 
be  directly  inoculated  by  the  sting  of  these  insects  is  absolutely  con- 
clusive. The  efficacy  of  measures  for  the  extermination  of  mosqui- 
toes, and  their  exclusion  from  houses  by  proper  screening,  has  been 
abundantly  demonstrated  both  at  home  and  abroad. 

It  is  gratifying  to  know  that  the  mystery  of  yellow  fever  was 
solved  by  the  work  of  Surgeons  Reed,  Carroll,  Lazear,  and  Agra- 
monte  of  the  United  States  Army,  and  Surgeons  Gorgas  and  Keane 
have  demonstrated  the  best  methods  for  the  prevention  of  yellow 
fever  and  malaria  by  waging  an  unceasing  warfare  against  the 
mosquitoes. 

Poultry,  pigeons,  and  household  pets,  like  dogs,  cats,  and  parrots, 
ought  not  to  be  kept  in  the  rooms,  as  they  contaminate  the  air,  harbor 
insects,  and  may  even  convey  disease  germs.  It  is  held  by  a  number 
of  authors  that  diphtheria  as  observed  in  chickens,  pigeons,  and  cats 
is  identical  with  the  human  disease.  Parrots  suffer  at  times  from 
a  pulmonary  disease,  which  is  transmissible  to  man,  while  certain 
forms  of  skin  disease  and  itch  may  be  conveyed  by  dogs  and  cats. 

There  is  some  evidence  to  show  that  a  certain  tapeworm  found  in 
the  dog  and  sometimes  in  children  undergoes  a  larval  stage  in  fleas 
and  dog  lice  and  when  swallowed  unconsciously  by  children  may  cause 
infection. 

What  has  been  said  of  the  desirability  of  general  cleanliness  applies 
with  equal  force  to  the  basement,  cellar,  attic,  3^ard,  outhouses,  gar- 
bage cans,  etc.  There  should  be  no  accumulation  of  rubbish  within 
or  without  the  premises.  Where  no  sewer  connections  exist,  the  out- 
houses should  be  kept  in  a  clean  condition,  and  the  seats  provided 
with  lids  so  as  to  exclude  flies.  It  is  also  a  good  plan  to  disinfect  the 
vault  or  receptacle  with  chlorinated  lime  or  fresh  whitewash,  etc. 

A  good  housewife  can  not  only  accomplish  a  great  deal  for  the 
health,  but  also  for  the  comfort  and  morals  of  the  family.     As  indi- 

«  Spillmann  and  Haushalter,  Comptes  rendus  105,  p.  352. 

*'  Hoffmann  Deutsche  Med.  Zeitung,  188S,  No.  57. 

^'  Iteport  of  tlie  Health  Officer,  District  of  Columbia,  1895. 


BBPOBTS   OP   THE  PBESIDENT's  HOMES  COMMISSION-.  113 

cated  by  our  German  authors,  general  order  and  neatness,  clean, 
white,  washable  curtains,  some  potted  plants,  and  a  few  suitable 
pictures,  avoiding  the  loud  chromos,  and  a  cheerful  and  refined  at- 
mosphere will  do  much  toward  keeping  the  husband  and  sons  from 
the  saloons. 

As  a  matter  of  fact,  much  may  be  done  to  transform  undesirable 
living  quarters  into  healthful  homes,  while  filth,  neglect,  and  slovenly 
housekeeping  often  convert  even  structurally  good  houses  into  verita- 
ble hotbeds  for  disease  germs.  So,  too,  persons  with  delicate  con- 
stitutions may,  by  attention  to  the  laws  of  health,  attain  to  a  good 
old  age,  while  the  physical  giant  by  a  reckless  life  soon  undermines 
his  general  health  and  goes  to  a  premature  grave. 

CARE   OF   THE    SKIN. 

The  skin  is  supplied  with  a  network  of  blood  vessels  and  nerves, 
and  is  a  sensory,  respiratory,  execretory,  and  heat  reflating  organ. 
As  a  sensory  organ,  it  combines  with  the  tactile  functions,  the  power 
of  perceiving  impressions  of  warmth  and  cold.  The  respiratory 
functions  of  the  skin  are  limited,  to  be  sure ;  nevertheless,  small  quan- 
tities of  oxygen  are  absorbed  and  carbonic  acid  is  eliminated.  Apart 
from  this,  the  skin  on  an  average  adult  eliminates  through  the  sweat 
glands  about  2^  pounds  of  water  a  day.  Human  sweat  contains 
about  2  per  cent  of  solid  constituents,  mostly  in  the  form  of  waste 
matter  or  impurities,  and  the  odor  varies  in  different  regions  of  the 
body  and  in  different  races.  The  skin  also  secrets  a  fatty  substance 
through  the  sebaceous  glands.  As  the  water  from  the  skin  evapo- 
rates, the  solid  matter  remains  upon  the  surface,  combines  with  dirt, 
harbors  germs,  and  readily  undergoes  decomposition,  which,  apart 
from  the  disagreeable  odors  so  characteristic  of  unclean  j)ersons,  also 
tends  to  mascerate  the  skin  and  is  liable  to  produce  "  galling  or  chaf- 
ing," pimples,  and  boils. 

Last,  but  not  least,  the  accumulation  of  this  matter  would  natu- 
rally close  the  pores  of  the  perspiratory  and  sebaceous  glands  and 
throw  the  work  of  eliminating  the  impurities  upon  other  organs. 

A  normal  cutaneous  function  is  doubtless  of  great  hygienic  im- 
portance, as  shown  by  the  occurrence  of  many  diseases  following  its 
suppression,  because  in  such  an  event,  in  addition  to  the  retention  of 
the  waste  matter  in  the  blood,  work  is  thrown  upon  the  kidneys  and 
other  eliminating  organs,  and  these,  if  already  weakened,  naturally 
break  down.  Since  the  functions  of  the  skin  depend  not  only  upon 
its  anatomical  intactness,  but  also  upon  cleanliness  and  a  proper  tone 
of  the  cutaneous  vessels  and  nerves,  a  rational  culture  of  the  skin 
demands:  (1)  that  it  should  be  freed  regularly  from  the  secretory 
products  and  particles  of  dirt;  (2)  that  the  cutaneous  nerves  retain 
their  normal  excitability  or  when  impaired  that  they  regain  their 
tone;  (3)  that  we  assist  the  skin  in  its  heat- regulating  functions,  so 
that  it  may  not  be  overtaxed.  All  of  which  may  be  accomplished 
by  ablutions,  baths,  and  suitable  clothing. 

ABLUTIONS  AND  BATHS. 

Regular  and  systematic  ablutions  with  soap  and  water  are  requisite 
for  reasons  already  given,  and  are  especially  necessary  when  engaged 
in  dirty  work  or  exposed  to  poisonous  dust.     In  addition  to  the 
S.  Doc.  644,  60-2 9 


114  REPORTS  OF   THE  PRESIDENT'S   HOMES  COMMISSION. 

chemical  effects  of  soap,  vigorous  friction  with  a  brush  may  be  em- 
ployed, not  omitting  the  finger  nails,  as  disease  germs  have  been  found 
in  nail  dirt. 

The  water  used  should  not  be  too  warm  for  the  body,  as  this  would 
relax  the  skin  and  increase  the  susceptibility  to  catching  cold.  If  the 
bathing  is  not  done  in  the  bath  tub,  it  will  be  well  to  wash  and  dry 
part  of  the  body  at  a  time.  In  any  event  the  surface  should  be  wiped 
dry  and  hard,  especially  the  hair,  since  wet  hair  is  calculated  to  pro- 
duce colds.  It  is  always  a  good  plan  to  wash  the  neck  and  chest  with 
cold  water,  so  as  to  harden  the  skin. 

We  will  now  brieiBiy  refer  to  the  different  forms  of  baths.  The  cold 
bath  is  usually  taken  in  a  tub  or  by  means  of  a  shower  or  needle  bath 
at  a  temperature  of  about  65°  for  adults.  It  should  not  last  over 
three  minutes.  Cool  baths  vary  from  65°  to  80°.  Tepid  baths  are 
taken  at  a  temperature  of  between  80°  to  90°,  continued  from  ten  to 
fifteen  minutes.  Warm  baths  vary  from  90°  to  100°,  and  are  generally 
employed  for  their  cleansing  effect.  In  addition,  there  are  steam 
or  Russian  baths,  the  Turkish  or  dry  hot-air  baths,  river  and  ocean 
baths,  swimming  pools  connected  with  public  baths,  medicated  baths, 
etc.  Swimming  baths  are  particularly  useful,  as  they  also  afford  an 
opportunity  for  muscular  exercise,  and  as  the  temperature  of  the 
water  is  rarely  above  80°.  Such  baths  are  both  cleansing  and  stimu- 
lating, and  therefore  an  excellent  tonic  for  the  skin.  All  baths  should 
be  followed  by  a  cool  douche  and  friction  with  a  rough  towel  should 
be  employed  until  the  skin  is  in  a  general  glow.  The  value  of  bathing 
is  so  fully  appreciated  that  the  building  regulations  of  this  city  com- 
pel a  bathroom  for  every  apartment  offered  for  rent.  No  community 
should  fail  to  make  provisions  for  public  baths,  both  in  summer  and 
winter.  The  beneficial  effects  upon  the  health  and  morals  of  the 
least  resourceful  people  can  not  be  too  strongly  emphasized.  The  old 
Roman  baths  were  prominent  features  of  the  daily  life  of  the  Romans, 
and  were  counted  among  the  choicest  privileges.  Eleven  large  and 
826  smaller  public  institutions  adorned  the  ancient  capital  during  the 
Diocletian  period,  and  the  baths  of  Caracalla,  the  ruins  of  which  can 
be  seen  to-day,  could  accommodate  1,600  bathers  at  one  time. 

The  following  sensible  rules  on  the  subject  of  bathing  have  been 
issued  by  the  English  Humane  Society,  and  are  well  worth  observing 
by  bathers : 

Avoid  bathing  within  two  hours  after  a  meal.  Avoid  bathing  when  exhausted 
by  fatigue  or  from  any  other  cause.  Avoid  bathing  when  the  body  is  cooling 
after  perspiration.  Avoid  bathing  altogether  in  the  open  air,  if,  after  having 
been  a  short  time  in  the  water,  there  is  a  sense  of  chilliness,  with  numbness  of 
the  hands  and  feet,  but  bathe  when  the  body  is  warm,  provided  no  time  is  lost 
in  getting  into  the  water.  Avoid  chilling  the  body  by  sitting  or  standing  un- 
dressed on  the  banks  or  in  boats,  after  having  been  in  the  water.  Avoid  remain- 
ing too  long  in  the  water,  but  leave  the  water  immediately  if  there  is  the  slight- 
est feeling  of  chilliness.  The  vigorous  and  strong  may  bathe  early  in  the 
morning  on  an  empty  stomach.  The  young,  and  those  who  are  weak,  had  better 
bathe  two  or  three  hours  after  meals;  the  best  time  for  such  is  from  two  to 
three  hours  after  breakfast.  Those  who  are  subject  to  giddiness  or  faintness, 
or  suffer  from  palpitation  or  other  sense  of  discomfort  at  the  heart,  should 
not  bathe  without  first  consulting  their  medical  adviser. 

CLOTHING. 

The  object  of  clothing,  apart  from  the  moral  and  aesthetic  aspect, 
is  to  aid  the  skin  in  its  heat-regulating  functions.    It  should,  there- 


BEPOHTS    OF    THE   PRESIDENT'S   HOMES   COMMISSION.  115 

fore,  afford  protection  against  heat  and  cold,  as  well  as  rain  and 
mechanical  irritation.  Clothing  must  be  adapted  to  climate  and  sea- 
sons, and  extremes  should  be  avoided ;  as  a  general  rule  warm  woolen 
goods  are  best  suited  for  winter  wear,  and  cotton  or  linen  for  warm 
weather.  It  should  be  understood,  however,  that  flannels  absorb  more 
dirt,  odors,  germs,  and  water  than  linen  or  silk,  whilst  cotton  oc- 
cupies an  intermediate  position.  The  question  of  wet  clothing, 
whether  from  perspiration  or  rain,  is  important,  as  the  drying  of 
clothing  on  the  body  involves  an  expenditure  of  animal  heat,  and  it 
is  not  a  matter  of  indifference  whether  this  takes  place  rapidly  or 
slowly.  It  is  a  fact  that  a  wet  cotton  shirt  or  sweater  feels  more  un- 
comfortable and  colder  than  a  wet  woolen  garment.  The  simple  rea- 
son is  that  the  cotton  garment  dries  more  rapidly,  but  it  abstracts 
during  the  same  time  more  animal  heat  than  flannels.  This  fact  is 
not  without  a  practical  bearing,  as  it  teaches  that  persons  who  per- 
spire easily  will  do  well  to  wear  flannels  next  to  the  skin,  and  this  is 
all  the  more  important  when  they  are  liable  to  draughts  or  abrupt 
changes  in  temperature. 

As  a  protection  against  cold,  wool  is  superior  to  either  cotton  or 
linen,  and  should  be  worn  for  all  underclothing.  In  case  of  extreme 
cold,  besides  wool,  leather,  fur,  or  waterproof  clothing,  on  account 
of  their  impermeability  to  air,  are  useful.  As  a  protection  against 
cold  winds,  for  equal  thickness,  leather  and  India  rubber  take  the  first 
rank,  wool  the  second.  As  a  protection  against  rain,  india  rubber  or 
oiled  canvas  clothing  is  the  best,  but  it  is  an  exceedingly  hot  dress, 
owing  to  its  impermeability  to  air,  which  causes  condensation  and 
retention  of  the  perspiration.  To  overcome  this  objection,  Dumas 
suggests  a  material,  which  is  waterproof  and  yet  permeable,  pre- 
pared as  follows :  The  garment  is  placed  in  a  7  per  cent  solution  of 
gelatine,  heated  to  a  temperature  of  100°  F.  After  immersion  for  a 
few  minutes  it  is  dried  in  the  air  and  after  drying  it  is  soaked  in  a 
three-fourths  of  1  per  cent  solution  of  alum  and  again  dried. 

As  a  protection  against  heat  in  the  shade,  the  thickness  and  con- 
ducting power  of  the  material  are  the  only  factors  to  be  considered. 
Texture  has  nothing  to  do  with  protection  from  the  direct  solar  rays ; 
it  depends  entirely  on  color,  and  white  is  the  best.  As  a  protection 
against  fire,  leather  clothing  is  generally  worn.  The  fabric  can  be 
rendered  noninflammable  by  the  addition  of  20  per  cent  of  tungstate 
of  soda  and  3  per  cent  of  phosphate  of  soda  to  ordinary  starch  sizing, 
while  cotton  or  linen  goods  may  be  treated  simply  with  starch  and 
borax,  in  the  proportion  of  a  teaspoonful  of  borax  to  one-half  pint  of 
starch. 

CLOTHING  AS  A  CAUSE  OF  DISEASE. 

Clothing  may  impair  the  functions  of  the  body  and  cause  disease 
(1)  by  improper  fitting,  which  leads  to  compression  of  blood  vessels 
and  nerves  and  interferes  with  the  normal  position  of  organs  and  the 
movements  of  the  body;  (2)  by  improper  selection  of  material  afford- 
ing either  insufficient  protection  or  overheating  a  part  or  the  whole 
of  the  body;  improper  material  may  also  produce  irritation  or  inter- 
fere with  the  vejntilation  of  the  skin;  (3)  by  wet  clothing,  which,  in 
drying,  may  abstract  sufficient  animal  heat  to  cause  peripheral  irrita- 
tion and  reflex  internal  congestions;  (4)  by  poisonous  dyes,  such  as 


116  EEPOBTS  OF  THE  PRESIDENT'S  HOMES  COMMISSION. 

compounds  of  arsenic  and  antimony,  chrome  yellow,  zinc  chloride, 
and  some  of  the  aniline  colors.  The  toxic  symptoms  may  manifest 
themselves  by  general  impairment  of  health  or  m  local  affections  of 
the  skin;  (5)  clothing  may  harbor  disease  germs,  and  a  number  of 
instances  are  on  record  in  which  itch,  smallpox,  tuberculosis,  and 
scarlet  fever  have  been  spread  by  second-hand  clothing  and  bedding. 
This  points  to  the  necessity  of  thorough  disinfectioi 

SPECIAL  ABRANGEMENT  OF  DBESS. 

The  head  dress. — As  long  as  the  head  is  covered  with  hair,  the  head 
dress  should  be  permeable  and  not  too  warm,  lest  headache  may  be 
induced ;  on  the  other  hand,  insufficient  covering  may  produce  neural- 
gia and  rheumatic  affections. 

The  head  and  eyes  should  always  be  protected  from  the  direct  rays 
of  the  sun,  and  for  this  purpose  broad-brmimed,  dark  felt  hats  for 
cold  weather  and  straw  or  some  other  light-colored  material  for 
summer  use  are  the  best. 

For  the  neck. — Nothing  should  be  worn  around  the  neck  which 
would  overheat  the  parts,  dilate  the  blood  vessels,  and  render  the  skin 
sensitive.  The  collars  should  be  loose  fitting,  so  as  not  to  compress 
the  blood  vessels.  The  neck  ought  to  be  bared  as  much  as  possible 
and  hardened  by  frequent  ablutions  with  cold  water. 

For  the  hody. — For  undergarments,  the  union  suits  are  the  best. 
They  should  secure  a  normal  amount  of  warmth  and  be  so  arranged 
as  not  to  interfere  with  the  free  movements  of  the  chest,  or  compress 
or  displace  the  abdominal  and  pelvic  organs.  For  these  reasons,  cor- 
sets and  waistbands  are  wholly  inadmissible.  Suspenders  should  be 
worn  by  both  sexes,  or  women  may  wear  a  bodice  arranged  for  the 
attachment  of  skirts,  so  as  to  suspend  their  weight  from  the  shoulders. 
Steel  corset  stays  and  tight  lacing  can  not  be  too  strongly  condemned, 
because  there  is  ample  evidence  that  they  have  caused  displacement 
and  disease  of  the  abdominal  and  pelvic  organs. 

The  stockings  should  be  made  of  some  warm,  permeable  material, 
such  as  wool  or  merino,  as  the  circulation  is  rather  feeble  in  the  lower 
extremities,  and  the  feet  are  more  liable  to  perspire.  They  should  be 
long  enough  to  reach  above  the  knees  and  there  fastened  with  some 
loosely-fitting  band.  Tight  elastic  bands  and  other  constricting  gar- 
ters are  liable  to  produce  varicose  veins. 

The  trousers  must  be  sufficiently  loose  around  the  waist  and  else- 
where to  permit  of  free  circulation  of  blood. 

FOOTWEAR. 

Boots  and  shoes  are  intended  to  protect  the  feet  from  the  uneven 
and  rough  surfaces  of  the  ground,  from  cold,  wet,  and  even  heat,  and 
must  be  constructed  so  as  to  meet  these  requirements.  It  is  needless  to 
insist  that  they  should  be  patterned  after  the  foot.  The  sole  of  a  shoe 
should  be  so  constructed  that  the  great  toe  touches  it  in  such  a  way 
that  a  line  projected  posteriorly  through  the  middle  of  this  toe  will 
strike  the  middle  of  the  heel.  The  heel  should  be  broad  and  low,  so 
as  not  to  throw  the  weight  on  the  toes.  Across  the  tread  and  toes  the 
sole  should  be  sufficiently  broad  to  permit  of  lateral  expansion.  The 
uppers  should  be  soft  and  flexible,  but  not  too  roomy,  and  should  fit 


EEPOETS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  117 

snugly  around  the  ankles  and  insteps.    Elastic  gaiters  are  preferablf^ 
to  laced  shoes. 

It  is  perhaps  needless  to  insist  that  cleanliness  in  body  and  cloth- 
ing is  next  to  godliness.  This  may  be  secured  by  frequent  bathing 
and  change  of  underwear.  It  is  also  a  good  plan  to  use  nightshirts 
or  pajamas,  so  as  to  afford  an  opportunity  for  a  thorough  airing  of 
the  underwear  worn  during  the  day.  If  in  spite  of  the  general  clean- 
liness there  should  be  indications  of  excessive  sweatmg  and  dis- 
agreeable odors,  especially  of  the  feet,  a  physician  should  be  consulted. 

BED   AND  BEDDING. 

Since  about  one-third  of  our  life  is  spent  in  bed,  something  should 
be  said  of  this  article  of  comfort  and  necessity.  As  the  object  of  the 
bed  is  to  promote  a  refreshing  sleep,  it  should  be  long  and  broad 
enough  to  permit  of  the  necessary  extension  of  the  body;  it  should 
be  elastic,  so  as  not  to  compress  the  soft  parts  unnecessarily,  and  it 
should  be  warm,  but  not  too  warm.  Metallic  bedsteads  are  preferable 
to  wood,  because  less  liable  to  be  infected  with  insects;  they  should 
be  provided  with  a  woven-wire  mattress  which  admits  of  free  cir- 
culation of  air.  Upon  this  may  be  placed  a  mattress  of  hair,  felt, 
cotton,  or  excelsior,  and  pillows  preferably  made  of  horsehair. 
Feather  pillows  are  too  heating  for  the  head,  unless  a  layer  of  paper 
has  been  interposed,  and  high  pillows  are  objectionable,  as  the  posi- 
tion of  the  sleeper  would  impede  the  movement  of  the  diaphragm. 
Sheets  and  pillowcases  of  cotton  for  winter  and  of  linen  for  summer 
are  necessaiy  to  prevent  irritation  of  the  skin  and  soiling  of  the  mat- 
tress, pillows,  and  blankets. 

The  most  suitable  coverings  for  a  bed  are  woolen  blankets;  they 
are  warm  and  their  permeability  admits  of  the  escape  of  gases.  For 
warm  w^eather  a  cotton  quilt  or  comforter  or  even  a  linen  sheet  is 
preferable.  The  bedding  should  be  aired  every  morning  and  exposed, 
whenever  practicable,  to  sunlight,  which  is  nature's  purifier  and 
destroys  all  forms  of  germs. 

"  Feather  beds  "  and  "  down  quilts  "  are  warmer  than  blankets,  as 
the  air  contained  in  the  feathers  is  a  bad  conductor  of  heat,  but  they 
are  only  suitable  in  very  cold  climates,  or  for  anaemic  and  delicate 
individuals,  because  they  overheat  the  body,  cause  dilation  of  the 
cutaneous  vessels,  and  consequently  relax  and  impair  the  tone  of  the 
skin. 

The  sleeper  should  lie  with  his  head  slightly  raised,  preferably 
with  the  body  inclined  to  the  right  side.  He  should  rise  rather 
slowly  from  the  recumbent  position,  since  a  sudden  change  to  the 
erect  position  not  only  accelerates  the  heart's  action,  but  also  changes 
the  blood  distribution  too  abruptly.  The  bed  should  be  so  placed 
that  the  occupant  is  not  disturbed  by  the  influence  of  light.  A  sound, 
refreshing  sleep  can  only  be  had  when  the  senses  are  no  longer  stimu- 
lated, and  light  is  a  stimulus  which  acts  even  through  the  closed 
eyelids. 

SLEEP. 

We  are  still  in  ignorance  of  the  exact  nature  of  sleep  or  the  sus- 
pension of  automatic  activity  of  the  brain.     Some  authors  maintain 


118  BEPORTS  OF  THE  PRESIDENT'S  HOMES  COMMISSION. 

that  it  is  due  to  an  accumulation  of  waste  products  in  the  blood  and 
central  nervous  sj^stem,  and  that  it  ceases  with  the  elimination  of 
these  products.  Others  believe  that  sleep  results  from  the  exhaustion 
of  the  supply  of  intra-molecular  oxygen,  while  still  others  attribute 
it  to  a  temporary  anaemia  of  the  brain.  On  the  whole,  there  is  much 
reason  for  assuming  that  the  refreshing  effects  of  sleep  are  due  to 
the  elimination  of  waste  products  from  the  system  and  the  absorption 
of  a  fresh  store  of  oxygen.  At  all  events,  Pettenkoffer  and  Voit 
found  that  of  the  954.5  grams  of  oxygen  absorbed  by  a  healthy  adult 
in  the  course  of  twenty-four  hours,  659.7  grams  are  absorbed  between 
6  o'clock  in  the  evening  and  6  o'clock  in  tne  morning. 

AMOUNT  OF    SLEEP   BEQUIEED. 

It  is  well  known  that  healthy,  new-bom  infants  sleep  all  day, 
except  while  nursing.  About  the  third  or  fourth  week  of  their  life 
they  may  remain  awake  for  one-quarter  of  an  hour,  in  addition  to 
their  nursing;  in  the  seventh  or  eighth  week  they  remain  awake 
one-half  hour,  and  in  the  fifth  month  about  one  hour ;  but  even  when 
a  year  old  a  child  sleeps  more  than  half  of  the  twenty-four  hours. 
During  the  second  and  third  year  it  sleeps  from  ten  to  twelve  hours 
at  night  and  from  two  to  two  and  one-half  hours  in  the  daytime. 
After  the  completion  of  the  third  year  the  necessity  for  sleep  in  day- 
time ceases. 

Uffelmann  has  made  a  series  of  careful  observations  and  believes 
that  "  healthy,  well-cared-for  children  between  4  and  6  years  of  age 
require  eleven  hours  of  sleep ;  at  7  years  of  age,  ten  to  ten  and  one- 
half  hours  of  sleep ;  at  10  j^ears  of  age,  nine  and  one-half  to  ten  hours 
of  sleep;  at  12  years  of  age,  nine  hours  of  sleep;  at  14  years  of 
age,  eight  and  one-half  hours  of  sleep;  youths  between  16  and  20, 
eight  and  one-half  hours  of  sleep;  adults,  seven  and  one-half  to  eight 
hours  of  sleep ;  while  the  aged  require  a  larger  amount  of  sleep." 

No  hard  and  fast  lines,  however,  can  be  drawn ;  some  children  and 
adults  can  get  along  with  less,  and  others  require  more  sleep.  On 
the  whole,  we  may  conclude  that  the  average  adult  requires  about 
eight  hours  of  sleep,  and  if  the  amount  is  materially  lessened  languor, 
pallor,  nervous  irritability,  and  general  peevishness  may  be  observed. 

Excessive  sleep  is  harmful,  as  it  tends  to  produce  sluggishness  of 
the  bodily  functions,  especially  of  the  digestive  organs.  It  lessens  tis- 
sue metamorphosis  and  favors  the  deposition  of  fat — not  to  mention 
the  bad  effects  of  the  prolonged  presence  in  a  polluted  atmosphere. 

We  are  also  beginning  to  understand  that  the  reason  why  an  excess 
of  sleep  instead  of  being  restful  to  intellectual  energy  is  rather  ex- 
haustive is:  After  a  certain  amount  of  sleep,  even  though  the  body 
continues  to  be  somnolent,  the  mind  awakes  and,  in  the  midst  of  the 
undirected,  rapidly  varying  mental  excursions  which  follow,  as  much 
nerve  force  and  mental  energy  is  expended  as  would  be  necessary  for 
the  more  continuous  thinking  of  regular  intellectual  work. 

Irregularity  in  sleep  is  always  objectionable.  The  human  body 
resents  irregular  habits  of  all  kinds.  Many  infants  sicken  because  of 
irregular  nursing,  and  we  all  experience  unpleasant  symptoms  when 
from  any  cause  our  regular  meal  hours  are  interrupted,  and  it  is  per- 
fectly natural  that  such  an  important  organ  as  the  brain  should 
demand  regularity  in  action  and  rest. 


REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  119 

Irregular  bed  hours  are  not  calculated  to  promote  a  sound  and 
refreshing  sleep.  Since  we  enjoy  the  best  sleep  before  midnight,  the 
hours  between  10  o'clock  p.  m.  and  6  a.  m.  or  11  p.  m.  to  7  a.  m.  are 
the  most  suitable. 

Opinions  differ  as  to  the  admissibility  of  a  nap  after  dinner,  and 
the  question  must  be  decided  by  individual  circumstances.  It  is  quite 
certain,  however,  that  there  is  no  physiological  necessity  for  such  a 
sleep  in  healthy  children  above  the  age  of  4,  nor  for  men  and  women 
in  their  best  years,  unless  they  have  taken  an  inordinate  amount  of 
food.  Persons  in  advanced  age  may  profit  by  a  short  rest,  which 
seems  often  demanded  by  an  overwhelming  drowsiness;  the  same 
may  be  said  of  delicate  and  anaemic  individuals  and  those  suffering 
from  diseases  of  the  digestive  system. 

DREAMS. 

In  spite  of  considerable  research  the  occult  character  of  dreams  has 
not  been  entirely  cleared  up,  although  psychologists  are  agreed  that 
they  constitute  a  manifestation  of  intellectual  life  involving  the 
expenditure  of  a  certain  amount  of  brain  force  or  mental  energy. 
Practical  experience  also  teaches  that  a  dreamless  sleep  is  in  every 
way  recuperative,  while  a  dreamful  night  produces  a  tired  feeling 
in  the  morning;  hence  dreams  should  be  avoided,  if  possible. 

There  is  much  reason  for  believing  that  the  old  custom  of  relating 
dreams,  and  the  attempt  to  interpret  them,  has  a  bad  effect  on  the 
minds  of  all,  and  especially  of  children,  as  it  tends  to  bring  about  a 
similar  mental  rambling  during  sleep  of  subsequent  nights.  Atten- 
tion has  recently  been  called  in  an  editorial  -(Journal  A.  M.  A.,  July 
28,  1907),  to  the  fact  that  children  suffer  more  frequently  from  night 
terrors,  which  are  really  overvivid  dreams,  on  Sunday  and  Monday 
nights.  This  is  partly  attributed  to  the  fact  that  the  children  have 
indulged  in  the  ''  imagination-intoxicating  "  colored  supplement  to 
the  Sunday  newspaper  with  its  horrors  and  its  dream  suggestions. 
Those  of  us  who  have  been  brought  up  in  rural  districts  and  have 
listened  to  dream  tales  and  folklore  and  perused  exciting  literature 
have  learned  that  all  of  this  is  productive  of  dreams  and  night 
terrors,  and  should  be  avoided. 

IMPORTANCE   OF    GOOD   TEETH. 

When  we  recall  the  physiology  of  digestion  it  is  scarcely  necessary 
to  point  out  the  importance  of  a  good  set  of  teeth  in  order  to  secure 
thorough  mastication  and  insalivation  of  the  food.  The  temperature 
of  food  and  drink  exerts  a  special  influence  on  our  teeth.  It  has  been 
shown  that  a  sudden  change  from  hot  to  cold  in  the  mouth  causes  the 
enamel  to  crack,  and  leads  to  premature  decay  of  the  teeth,  because 
the  microbes  in  the  mouth  will  find  these  fissures  a  suitable  lurking 
place  for  their  destructive  work. 

The  teeth  should  never  be  used  for  the  purpose  of  cracking  nuts. 
Microbes  of  every  description  abound  in  the  mouth,  and  find  in  the 
presence  of  lodged  and  decaying  particles  of  food  a  suitable  medium 
for  their  multiplication.  In  order  to  prevent  their  destructive  effects, 
cleanliness  of  the  mouth  is  absolutely  essential.  This  can  be  secured 
by  brushing  the  teeth  with  water  and  castile  soap  after  each  meal 


120  REPOKTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

and  before  retiring.  In  case  particles  of  food  can  not  be  thus  dis- 
lodged, a  soft  silk  thread  drawn  between  the  teeth  will  accomplish 
the  purpose  more  effectively  and  wisely  than  a  toothpick.  If  the 
teeth  are  already  painful,  or  show  evidence  of  decay  or  of  accumula- 
tion of  tartar,  a  dentist  should  be  consulted.  It  is  a  wise  plan  to  have 
the  teeth  examined  once  a  year,  and  as  there  are  free  dental  infirm- 
aries, the  question  of  cost  should  not  deter  even  the  least  resourceful 
people. 

HABIT   AND    REGULARITY   OF   THE    BOWELS. 

As  i)ointed  out  by  Hammond,^  when  we  perform  an  act  under  the 
operation  of  certain  impressions,  there  is  a  tendency  toward  the  per- 
formance of  a  similar  act,  if  like  influences  are  brought  to  bear  upon 
the  organism.  "  This  disposition  to  repetition  prevails  in  nearly 
every  function  of  the  body  and  mind  until  some  powerful  force  inter- 
venes." It  is  shown  by  the  sensation  of  hunger  and  thirst  which 
occur  at  customary  meal  hours,  the  desire  to  evacuate  the  bowels  at 
the  same  hour  of  the  day,  the  desire  for  sleep,  the  hour  of  awakening, 
and  the  inexpressible  feeling  excited  by  the  want  of  a  smoke  or  a 
customary  stimulant. 

CONSTIPATION. 

When  regularity  of  the  bowels  is  established,  the  desire  to  go  to 
the  stool  returns  at  the  same  hour.  If  this  tendency  is  resisted,  it  is 
not  long  before  constipation  becomes  the  rule,  with  all  its  attending 
consequences  of  ill  health.  The  most  natural  remedy  to  correct  this 
morbid  habit  will  be  persistent  effort  to  secure  an  evacuation  every 
day  at  a  fixed  hour,  aided  by  the  use  of  succulent  vegetables  and 
fruits,  and  if  necessary  by'  small  doses  of  olive  oil,  cotton-seed  oil,  or 
Epsom  salts  and  water. 

One  of  the  most  baneful  effects  of  constipation  is  hypochondry — a 
nervous  and  mental  condition  brought  about  by  absorption  of  poison- 
ous products  in  the  intestinal  tract,  and  the  continued  action  of  the 
mind  upon  some  one  organ  or  function  supposed  to  be  disordered, 
notably  the  heart,  liver,  and  stomach.  The  disease  appears  most 
commonly  in  irritable  individuals  and  in  those  exhausted  from  a 
variety  of  causes.  Such  persons  are  of  sound  judgment  in  other 
respects,  but  reason  erroneously  on  whatever  concerns  their  own 
health.  In  these  cases,  apart  from  correcting  the  digestive  derange- 
ments, it  is  often  necessary  to  act  upon  the  mind  by  keeping  it  occu- 
pied with  matters  which  will  divert  the  thoughts  of  the  patient  from 
himself.  This  is  often  readily  accomplished  on  the  golf  links  in 
persons  who  require  exercise. 

CARE  OF  THE  EYES. 

It  is  well  known  that  exposure  of  the  eyes  to  the  direct  rays  of  the 
sun  may  cause  inflammation  of  the  retina  and  even  total  blindness, 
and  similar  effects  may  be  produced  by  the  reflected  rays  of  the  sun 
from  mirrors,  sheets  of  water,  white  walls,  and  snow  (snow  blind- 
ness) .  On  the  other  hand,  defective  lighting,  as  pointed  out  on  page 
88,  also  produces  mischief,  and  must,  therefore,  be  avoided  in  the 

•  Treatise  on  Hygiene,  Wm.  A.  Hammond,  1863,  p.  122. 


EEPORTS   OF   THE  PKESIDENt's  HOMES  COMMISSION.  121 

home  as  well  as  in  the  shop.  Sudden  transposition  from  light  to 
dark  or  dark  to  light  is  also,  injurious  and  may  cause  serious  diseases 
of  the  eyes.  Whenever  there  is  any  evidence  of  redness,  inflamma- 
tion, pain,  watering,  or  "  mattering  "  of  the  eyes,  a  physician  should 
be  consulted.  While  free  bathing  of  the  eyes  with  cold  water  may 
exert  a  preventive  and  tonic  effect,  the  value  of  good  eyesight  is  too 
great  to  trust  to  domestic  remedies,  or  even  to  the  services  of  an 
optician.  Whenever  there  is  any  diifficulty  in  reading,  accompanied 
by  pain  or  headache,  an  occulist  should  be  chosen.  When  we  recall 
the  number  of  accidents  which  befall  the  eyes  in  many  occupations, 
the  importance  of  protective  goggles  must  be  apparent. 

EAR  AND  NOSE. 

These  organs  should  be  kept  clean.  There  is  danger  from  lodg- 
ment of  foreign  bodies,  particularly  in  children,  which  may  impair 
the  hearing  for  life,  especially  when  injudicious  attempts  at  removal 
have  been  made.  In  such  instances  it  is  always  best  to  consult  a 
competent  physician.  The  chief  function  of  the  nose  evidently  is  to 
arrest  more  or  less  of  the  dust  and  germs  upon  its  mucous  surfaces, 
and  in  cold  weather  to  warm  the  inspired  air.  Hence,  the  importance 
of  cleanliness  and  of  breathing  through  the  nose  instead  of  the  mouth. 
In  order  to  do  this  without  discomfort,  it  is  necessary  that  there  be 
no  obstruction  in  the  nasal  passages,  and  persons  suffering  from 
catarrh  or  other  symptoms  of  difficult  breathing  will  do  well  to 
undergo  treatment.  In  this  connection  attention  should  be  called  to 
the  advantages  of  so-called  "  deep  breathing  "  in  the  open  air  or  near 
an  open  window.  This  is  best  accomplished  by  taking  10  or  12  deep 
inspirations  morning  and  evening,  so  as  to  inflate  the  lungs  to  their 
fullest  expansive  capacity.  This  practice  is  believed  to  secure  a  thor- 
ough ventilation  of  all  the  air  vesicles  and  to  increase  the  power  of 
resistance  to  the  invasion  of  the  tubercle  bacillus. 


Chapter  II. 
ALIMENTATION  AND  FOODS. 

The  fact  that  proper  nutrition  of  the  body  is  important  for  the 
enjoyment  of  health  has  long  since  been  recognized,  and  we  all  agree 
that  the  character  of  food  not  only  influences  the  growth  and  develop- 
ment of  the  child,  but  also  the  health,  power  of  endurance  and  resist- 
ance in  the  adult,  and  often  plays  a  most  important,  if  not  decisive, 
role  in  the  treatment  of  disease. 

The  human  organism  is  made  up  of  about  60  per  cent  of  water,  19 
per  cent  of  protein  compounds,  15  per  cent  of  fats,  and  6  per  cent 
of  mineral  salts,  all  of  which  are  sooner  or  later  consumed,  involving 
certain  expenditures  which  must  be  covered  if  health  and  life  are  to 
be  preserved. 

The  process  by  which  the  repair  of  waste  is  supplied  is  called 
alimentation  or  nutrition,  and  the  entire  process  involved  in  the  waste 
and  repair  of  tissues  is  called  metabolism.  The  simple  chemical 
compounds  which  are  appropriated  by  the  system  are  called  alimen- 
tary principles  or  nutrients,  and  the  simple  or  artificial  combinations 
of  several  nutrients  are  called  nutriment  or  food. 


122  REPOETS  OF  THE  PBESIDENt's  HOMES  COMMISSION. 

The  cause  of  the  constant  consumption  of  the  proximate  principals 
of  the  body  must  be  looked  for  in  the  functional  activity  of  the  cells. 
We  know  that  they  take  up,  utilize,  disintegrate,  and  eliminate 
matter ;  this  gives  rise  to  the  generation  of  heat  and  the  evolution  of 
force  or  mechanical  power,  both  of  which  are  the  result  of  latent 
energy  contained  in  the  substances  introduced  into  the  system  as  food. 

The  heat  and  vital  force  of  the  heart  and  other  muscles  of  the  body 
have  their  source  clearly  in  the  process  of  oxidation  of  carbon  and 
oxygen,  which  primarily  takes  place  in  the  cells;  and  all  nutrients 
containing  carbon  and  hydrogen  contribute  to  the  generation  of  heat 
and  the  evolution  of  muscular  force. 

The  chief  objects  of  food  are,  according  to  Atwater,  to  form  the 
material  of  the  body  and  repair  its  waste,  and  to  yield  heat  to  keep 
the  body  warm  and  muscular  and  other  power  for  the  work  it  has 
to  do.  The  amount  of  energy  contained  in  different  foodstuffs  has 
been  measured  in  the  laboratory  by  the  amount  of  heat  evolved  during 
their  combustion  by  means  of  an  apparatus  called  the  calorimeter. 
The  unit  commonly  used  is  the  calorie,  by  which  we  understand  the 
amount  of  heat  required  to  raise  the  temperature  of  a  pound  of  water 
1®  F.,  or  if  transformed  into  mechanical  power,  such  as  the  muscles 
use  to  do  their  work,  a  calorie  represents  force  which  would  be  suffi- 
cient to  lift  one  ton  1.54  feet.  Atwater  gives  the  following  general 
estimate  for  the  average  amount  of  heat  and  energy  in  one  pound  of 
each  of  the  classes  of  nutrients : 

Calories. 

1  pound  of  protein 1,  860 

1  pound  of  fat 4,  220 

1  pound  of  carbohydrates 1,  860 

Since  the  supply  of  foodstuff  or  income  must  be  regulated  by  the 
consumption  or  outgo,  it  is  essential  that  the  consumption  should  be 
determined.  Experiments  of  this  kind  are  made  in  an  apparatus 
called  the  "  respiration  calorimeter,"  and  include  not  only  a  quantita- 
tive analysis  of  the  food,  drink,  and  air  consumed  by  the  man  and  of 
all  the  excretory  products,  which  make  up  the  income  and  outgo  of 
the  system,  but  also  a  careful  estimate  of  the  energy  represented  by 
ingested  material,  as  well  as  the  energy  liberated  from  the  body  in 
the  various  excreta,  in  heat  and  mechanical  energy. 

The  balance  of  income  and  expenditure  is  thus  made,  and  the  gain 
or  loss  of  material  of  the  body,  with  different  kinds  and  amounts  of 
food,  and  under  different  conditions  of  muscular  exercise  and  rest,  is 
determined.  By  means  of  these  experiments  Professor  Atwater  has 
been  able  to  verify  the  law  of  the  conservation  of  energy  as  applied 
to  the  animal  organism,  and  has  shown  that  every  unit  of  energy 
which  enters  the  body  as  potential  energy  of  the  food  will  leave  the 
body  in  potential  energy  as  excreta,  in  heat  radiated  from  the  body, 
or  in  mechanical  work  done  by  the  muscular  system.  The  material 
income  of  the  body  must  balance  the  material  outgo,  and  the  energy 
income  of  the  body  must  balance  the  energy  outgo. 

According  to  the  classical  experiments  of  Pettenkoffer  and  Voit, 
nearly  forty  years  a^o,  the  waste  products  of  a  healthy  adult  weigh- 
ing 154  pounds,  during  twenty- four  hours,  at  rest  amounted  to  16.8 
grams  of  nitrogen  in  the  urine,  275  grams  of  carbon,  and  2,500  grams 
of  water,  while  the  wast«  products  of  the  same  individual,  performing 
moderately  hard  muscular  work,  amounted  to  18.8  grams  of  nitrogen, 


REPORTS   OF   THE  PRESIDENT  S  HOMES   COMMISSION. 


123 


328  of  carbon,  and  2,190  grams  of  water,  and  from  these  experiments 
the  authors  named  concluded  that  the  following  quantities  of  nutrients 
are  required  during  twenty-four  hours : 


Protein. 

Fata. 

Carbohy- 
drates. 

Man  without  muscular  work 

QratM. 
118 
118 
146 

Oram*. 

45 

56 

100 

Orams. 
450 

Man  with  moderate  muscular  work 

500 

Man  with  hard  muscular  work 

500 

Professor  Chittenden's  experiments,  conducted  about  three  years 
ago,  indicate  that  the  nitrogen  equilibrium  is  preserved  on  a  daily 
intake  of  8.5  to  9.5  grams  of  nitrogen,  or  about  55  grams  of  nitroge- 
nous food,  so  that  the  protein  ration  of  Voit  may  be  cut  in  two,  pro- 
vided the  fats  and  carbohydrates  are  introduced  in  sufficient  quantities 
to  bring  the  full  value  up  to  2,500  or  2,600  calories.  Other  authorities, 
however,  believe  that  it  would  be  unwise  to  reduce  the  protein  ration 
below  100  grains  or  3.5  ounces  a  day. 

One  of  the  difficulties  in  the  way  of  setting  up  exact  standards  is,  as 
pointed  out  by  Professor  Atwater,  that  "  different  individuals  of  the 
same  class  differ  widely  in  their  demands  for  food  and  in  the  use 
they  make  of  it.  Two  men  of  like  age,  size,  build,  and  occupation  may 
live  and  work  side  by  side.  One  will  eat  more  and  the  other  less, 
while  both  do  the  same  amount  of  work,  or  both  may  eat  the  same  food 
and  do  the  same  work,  and  one  will  be  fat  and  the  other  lean,  or  both 
may  have  the  same  diet  and  yet  one  w  ill  be  strong  and  vigorous  and 
able  to  do  a  great  deal  of  work,  while  the  other  will  be  weak  and  able 
to  accomplish  but  little.  Just  why  individuals  differ  in  their  ways  of 
utilizing  their  food  and  how  to  measure  the  differences  and  make  diet- 
ary rules  to  fit  them  exactly,  are  problems  which  the  physiological 
chemist  has  not  yet  solved." 

Theie  are  also  persons  who,  because  of  some  peculiarity  of  the  diges- 
tive system,  can  not  use  foods  which  for  people  in  general  are  most 
wholesome  and  nutritious.  Some  persons  can  not  eat  eggs,  others 
suffer  if  they  take  milk,  others  have  to  avoid  certain  kinds  of  meat  or 
fruit  and  all  these  idiosyncracies  indicate  that  the  nutrition  of  man 
is  not  a  mere  matter  of  grams  of  protein,  fats,  and  carbohydrates.  In 
fact  we  live  not  upon  what  we  eat,  but  upon  what  we  digest  and 
assimilate. 

The  whole  subject  of  dietary  standards  is  still  in  its  infancy  and  the 
best  we  can  do  is  to  make  estimates  which  apply  to  averages  rather 
than  individual  cases.  In  a  general  way  we  may  conclude  that  the 
needs  of  the  economy  are  influenced  (1)  by  the  height  and  weight  of 
the  individual,  amounting  to  a  difference  of  40  to  50  calories  for  each 
kilogram  in  body  weight;  (2)  by  the  temperament — nervous  and 
excitable  persons  require  more  food  than  those  of  a  phlegmatic  tem- 
perament; (3)  by  muscular  activity,  which  involves  not  only  an  in- 
creased expenditure  of  carbon,  but  also  increased  consumption  of  pro- 
tein ;  (4)  age,  in  so  far  as  during  active  growth  there  is  also  a  more 
active  metabolism  and  children  consume  more  for  each  kilogram  of 
their  weight  than  adults ;  on  the  other  hand,  with  advancing  years  tis- 
sue metamorphosis  becomes  less  active;  (5)  sex  influences  me  amount 


124  KEPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

of  tissue  consumption  only  in  so  far  as  there  is  a  difference  in  weight 
and  muscular  activity ;  an  exception  should  be  noted  in  pregnant  and 
nursing  women,  who  doubtless  should  receive  a  more  liberal  supply 
of  proteids;  (6)  by  temperature  and  climate.  The  injfiuence  of  low 
temperatures  results  in  increased  oxidation  of  carbon;  hence  an 
instinctive  craving  for  more  fatty  food  and  the  carbohydrates,  sugar 
and  starches,  during  the  winter  months  and  in  cold  climates.  In 
the  summer  months  and  in  warm  climates  there  is  a  repugnance  for 
fat  and  a  craving  for  refreshing  food  and  drinks,  and  hence  the  mini- 
mum amount  of  fat,  about  40  grams,  and  between  300  to  400  grams  of 
carbohydrates  with  a  normal  protein  ration  will  meet  the  require- 
ments. 

Foodstuffs  are  classified  according  to  their  proximate  composition 
as  follows: 

First.  Organic,  nitrogeneous,  as  proteids  or  albuminoids;  non- 
nitrogenous  (a)  fats,  (h)  carbohydrates,  (c)  vegetable  acids. 

Second.  Inorganic — mineral  salts  and  water. 

Third.  Food  accessories,  as  tea,  coffee,  and  condiments. 

The  first  two  classes  of  foodstuff  are  essential  to  life ;  the  third  class 
is  important  as  favoring  palatability  and  digestibility. 

The  true  nutrients  are  protein,  fats,  and  carbohydrates. 

The  term  "  protein  "  includes  most  of  the  nitrogeneous  food  com- 
pounds, such  as  albuminoids,  gelatinoids,  and  extractives. 

1.  The  albuminoids  include  all  substances  allied  in  their  chemical 
composition  to  egg  albumin,  and  have  an  average  composition  of  N 
16  per  cent,  C  53  per  cent,  H  7  per  cent,  O  23  per  cent,  S  1  per  cent. 
They  are  found  in  eggs,  lean  part  of  meat,  milk,  curds,  and  the  gluten 
of  wheat,  the  leguminous  plants,  etc.  The  principles  of  this  group 
during  digestion,  with  the  exception  of  nuclein,  are  converted  into 
soluble  peptones  or  alkaline  albuminates  and  readily  absorbed  as 
such ;  they  are  the  chief  tissue  formers  of  the  muscles  and  tendons  of 
the  body,  but  apart  from  this  purely  plastic  function  they  also  play 
a  role  in  oxidation  and  therefore  in  the  generation  of  heat  and  energy. 
At  all  events  they  can  take  the  place  of  fats  and  carbohydrates  if  the 
body  has  not  enough  of  one  or  the  other  for  fuel,  but  neither  of  the 
latter  can  take  the  place  of  albuminoids  in  building  and  repairing 
tissue. 

2.  The  gelatinoids  resemble  the  albuminoid  group  in  their  chemical 
composition;  they  are  derived  from  ossein  and  chondrin  (connective 
tissue)  and  are  changed  to  gelatin  on  heating  with  water  and  during 
digestion  into  gelatin-peptones.  They  are  not  tissue  formers,  but 
serve  as  fuel,  and  thus  protect  the  protein  fats  and  carbohydrates 
from  consumption.  Indeed  100  grams  of  gelatin  can  take  the  place 
of  36  grams  of  albumin  and  25  grams  of  fat,  but  unfortunately  large 
quantities  are  liable  to  cause  nausea  and  diarrhea,  probably  because 
the  undigested  particles  undergo  rapid  decomposition. 

3.  The  extractives,  so  called  because  they  are  extracted  from  flesh 
by  water,  are  known  in  the  laboratory  as  creatin,  creatinin,  carnin, 
etc.,  and  are  the  chief  constituents  of  beef  tea  and  meat  extracts. 
Neither  the  extractives  or  amids  found  in  vegetables  like  asparagus, 
betain,  etc.,  can  replace  or  exert  a  sparing  effect  on  the  consumption  oi 
albumin ;  they  are  therefore  alimentary  aids  and  not  true  foods. 

Indeed  Kemmerich,  over  twenty  years  ago,  pointed  out  that  they 
are  not  free  from  danger  on  account  of  the  large  percentage  of  potas- 


EEPORTS   OF   THE  PBBSIDENt's  HOMES  COMMISSION.  125 

slum  salt;  at  all  events,  it  has  been  shown  that  animals  fed  exclu- 
sively on  meat  extracts  die  more  quickly  from  starvation  than  do 
those  deprived  entirely  of  food,  and  Fothergill,  one  of  the  most  dis- 
tinguished English  food  experts,  exj^ressed  the  opinion  "  that  more 
lives  have  been  lost  by  a  mistaken  belief  in  the  food  value  of  beef  tea 
than  by  all  the  Napoleonic  wars."  Beef  tea  acts  as  a  regulator  and 
stimulant  of  digestion  and  assimilation  and,  like  the  meat  broths,  is 
useful  in  the  dietary  of  sickness,  provided  we  combine  it  with  eggs, 
farinaceous  food,  and  small  quantities  of  gelatin.  The  meat  peptones 
and  fluid  meat,  containing,  as  they  do,  considerable  proportions  of 
true  nutriments,  are  much  to  be  preferred,  but  their  nutritive  value  in 
the  treatment  of  disease  must  not  be  overestimated. 

4.  The  hydrocarbons  of  fats,  whether  derived  from  the  animal  or 
vegetable  kingdom,  are  emulsified  and  saponified  by  the  pancreatic 
juice  and  bile  and  finally  reach  the  tissues,  where  they  become  an 
integral  part  of  the  cells.  Apart  from  aiding  in  the  reconstruction  of 
fatty  tissues,  they  undergo  oxidation,  and  thus  supply  heat  and  energy. 
Since  the  cells  without  exception  contain  more  or  less  fat,  it  being,  in 
conjunction  with  albumin,  the  principal  constituent  of  nerve  tissue, 
a  store  of  adipose  tissue,  especially  during  febrile  conditions,  hard 
work,  or  whenever  the  consumption  exceeds  the  supply,  is  very  desir- 
able. If  the  supply  of  fat  exceeds  the  demand,  the  excess  is  eliminated 
in  the  feces,  while  other  portions  are  stored  up  in  the  visceral  cavities 
and  subcutaneous  tissues,  where  it  serves  as  a  nonconductor  of  heat, 
gives  beauty  and  form  to  the  body,  and  protects  various  important 
structures  from  injury,  but  most  important  of  all,  if  the  supply  should 
be  cut  off,  or  the  consumption  be  increased,  as  during  febrile  condi- 
tions and  hard  work,  this  reserve  fuel  can  be  drawn  upon  for  the 
production  of  heat  and  energy,  and  thus  protect  the  more  important 
protein  compounds  from  oxidation. 

5.  The  carbohydrates  are  nonnitrogenized  principles  which,  in  ad- 
dition to  carbon,  contain  hydrogen  and  oxygen  in  the  proportion  to 
form  water.  The  formula  for  starch  or  dextrose  is  CgHioOg  and  that 
of  sucrose  or  cane  sugar  C12H22O11. 

The  carbohydrates,  whatever  their  source,  enter  the  blood  as  sugar; 
normal  blood  contains  about  0.1  per  cent  and  rarely  more  than  0.2 
per  cent  of  sugar.  The  liver  prevents  a  large  accumulation  by  stor- 
ing it  up  as  glycogen,  or  liver-starch,  which  under  the  influence  of  a 
])eculiar  ferment  is  reconverted  into  sugar  as  the  needs  of  the  economy 
demand,  and  any  further  excess  is  removed  by  the  kidneys.  The  sugar 
in  the  blood  is  carried  to  the  tissues,  where  it  undergoes  oxidation, 
yielding  heat  and  energy.  It  is  generally  held  that  carbohydrates 
when  ingested  in  liberal  amounts  may  be  converted  into  fat.  How 
this  is  accomplished  is  not  yet  understood,  but  it  may  partly  be  ac- 
counted for  by  the  fact  that  the  oxidation  of  sugar  saves  the  fatty 
and  protein  tissues  from  destruction  and  allows  the  fat  in  the  diet  to 
form  new  fatty  tissues. 

6.  The  pectin  substances,  like  pectose  and  pectin,  found  in  fruit 
and  tubers,  form  jellies  with  water,  are  related  to  the  carbohydrates, 
and  probably  serve  similar  purposes  in  the  economy. 

7.  The  organic  acids,  like  tartaric,  mallic,  citric,  acetic,  oxalic,  and 
lactic  acids  existing  in  fresh  vegetables  and  fruits,  fresh  meats  and 
milk,  are  transformed  in  the  system  into  carbonates  and  as  such  pre- 
serve the  alkalinity  of  the  blood  and  other  fluids.    In  the  absence  of 


126  EEPOBTS  OF  THE  PRESIDENT'S  HOMES  COMMISSION. 

these  acids  the  blood  becomes  impoverished  and  scurvy  is  liable  to 
develop.  An  excess  is  likely  to  interfere  with  digestion,  especially 
with  the  conversion  of  starch  into  sugar,  not  to  mention  the  laxative 
and  diuretic  properties. 

8.  The  fact  that  60  per  cent  of  the  body  is  composed  of  water  clearly 
indicates  that  a  sufficient  amount  must  be  introduced  to  make  up  the 
loss  sustained  by  its  excretion  through  the  lungs,  kidneys,  skin,  and 
feces.  It  is  simply  necessary  to  recall  the  physiological  functions  of 
water  in  the  absorption  and  assimilation  of  food,  the  elimination  of 
waste  products,  and  its  role  as  a  heat  regulator  to  appreciate  that  a 
deficiency  is  certain  to  be  followed  hj  injurious  effects. 

9.  The  mineral  salts,  which  furnish  about  6  per  cent  of  the  body 
weight,  are  potassium,  calcium,  magnesium,  sodium,  and  iron  in  com- 
bination with  chlorine,  phosphoric,  sulphuric,  and  carbonic  acid.  The 
phosphates  of  lime,  potash,  and  magnesia  contribute  largely  to  the 
formation  of  bone,  and  are  also  essential  for  the  growth  of  the  nervous 
system.  Iron  is  required  for  the  red  blood  corpuscles  and  coloring 
matters,  the  chlorides  are  the  source  of  hydrochloric  acid  in  the  gas- 
tric juice  and  keep  the  globulins  of  the  blood  and  other  fluids  of  the 
body  in  solution.  Potassium  for  the  blood  cells  and  solid  tisues  and 
sodium  for  the  intercellular  fluids  are  all  essential  for  the  growth  and 
repair  of  the  tissues;  of  these  certain  quantities  are  daily  eliminated 
and  must  be  replaced.  Forster  has  shown  that  when  the  supply  in 
animals  is  suspended,  serious  digestive  derangements,  depressions  of 
the  nervous  system,  muscular  weakness,  trembling,  paralysis,  stupor, 
and  death  ensue. 

Voit's  experiments  indicate  that  an  insufficient  supply  of  the  salts  of 
lime  produced  rickets  in  growing  animals,  and  children  fed  largely 
upon  farinaceous  food  are  proverbially  prone  to  this  affection ;  incom- 
plete absorption  of  these  salts  produces  the  same  effect,  as  shown  by 
the  frequent  development  of  rickets  after  prolonged  diarrheal 
affections. 

An  insufficient  supply  of  iron  or  incomplete  absorption  may  give 
rise  to  chlorosis  and  anaemia,  and  a  deficiency  of  the  potassium  salts 
in  consequence  of  an  exclusive  animal  diet  is  believed  to  favor  the 
development  of  scurvy,  but  as  this  disease  has  developed  among 
prisoners  who  subsisted  largely  on  a  vegetable  diet,  I  quite  agree  with 
Fluegge  that  the  absence  of  fresh  vegetables,  more  especially  the 
organic  acids  contained  therein,  is  the  most  important  factor  in  the 
development  of  scuryy.  An  excess  of  chloride  of  sodium,  as  during 
a  constant  salt  meat  diet,  doubtless  predisposes  to  scurvy,  probably 
because  the  chloride  of  sodium  exerts  a  decomposing  effect  on  the 
potassium  combinations  of  the  blood  corpuscles. 

The  question  as  to  the  exact  requirements  of  the  inorganic  salts  in 
the  system  has  not  yet  been  solved.  According  to  Boussingault  an 
adult  requires  from  60  to  90  mgrs.  of  iron  daily,  and  according  to 
Konig,  persons  upon  a  mixed  diet  require  from  12  to  20  grams  of 
sodium  chloride. 

In  reference  to  accessory  foods,  such  as  spices  and  condiments, 
extractives  of  meat,  bitter  principles  contained  in  vegetables,  tonics, 
and  the  alkaloidal  beverages  like  coffee,  tea,  and  cocoa,  we  can  not 
stop  to  point  out  their  physiological  effects,  except  to  say  that,  since 
.they  act  largely  through  the  nervous  system,  every  excess  over  and 
above  the  amount  required  will  produce  mischiei;  indeed  we  may 


REPORTS   OF   THE  PRESIDENT  S  HOMES  COMMISSION. 


127 


safely  conclude  that,  while  the  use  of  accessory  foods  in  moderation 
increases  temporarily  the  elasticity  of  mind  and  body  and  a  desire  and 
capacity  for  work,  their  abuse  is  fraught  with  danger. 

FOOD. 

The  two  broad  divisions  of  food  are  animal  and  vegetable,  although 
the  mineral  kingdom  unites  to  furnish  man  with  sustenance.  Animal 
food  is  characterized  by  a  predominance  of  the  proteids  and  mineral 
salts,  while  vegetable  food  is  rich  in  carbohydrates,  which,  however, 
like  the  vegetable  albumin,  are  inclosed  in  cells  composed  of  a  fibrous 
frame-work  known  as  cellulose,  and  therefore  more  difficult  to  be 
acted  upon  by  the  digestive  fluids. 

An  excess  of  this  cellulose  usually  excites  undue  peristaltic  action 
and  consequently  a  more  rapid  transit  of  the  intestinal  contents,  and 
thus  interferes  with  the  complete  utilization  of  the  nutritive  material ; 
a  certain  amount  of  cellulose  is  necessary,  however,  to  promote  the 
action,  because  if  the  food  was  so  nutritious  as  to  be  entirely  absorbed, 
there  would  be  very  little  solid  to  transmit  and  the  action  of  the  bow- 
els would  become  irregular  and  unsatisfactory.  Hence  the  good 
effect  of  graham  bread,  vegetables,  and  fruit  in  habitual  constipation. 

ANIMAL   FOOD. 
MEAT. 


In  a  dietetic  point  of  view  we  mean  by  meat  the  muscular  substance 
with  its  connective  tissues,  the  fat  and  various  juices  deposited 
therein. 

The  nutritive  value  of  meat  depends  upon  the  large  percentage  of 
protein.  Dark  meats,  such  as  game  and  wild  fowl  and  beef,  contain 
from  18  to  25  per  cent  of  albumin. 

The  relative  amount  of  nutritive  matter  is  shown  in  the  following 
table  based  upon  analyses  by  Konig,  Voit,  and  others : 


Proteids. 

Gelatin. 

Fat. 

Salts. 

Extract- 
ives. 

Beef                 

Per  cent. 
18.4 
16.3 
17.5 
15.5 
15.3 
19.8 
21.7 
23.3 
21.5 
19.3 
21.1 

Per  cent. 
1.6 
4.5 

Per  cent. 

0.9 

1.0 

1.5 

6.5 

28.9 

20.8 

2.5 

1.1 

2.5 

16.3 

22.9 

Per  cent. 
1.3 
1.0 
1.2 
1.2 
.8 
5.5 
1.0 
1.1 

Per  cent. 
1  9 

Veal 

.9 

1  4 

Pork   fresh    lean 

1.5 

1  3 

Ham  smoked  lean 

Game  ( rabbit) 

Broiler  chicken      ..                        

1.0 
1.0 

Turkey 

According  to  the  foregoing  table,  game  and  fowl  are  richest  in  pro- 
teids, salts  and  extractives;  veal  and  pork  are  poorest  in  proteids; 
veal  richest  in  gelatin ;  ham  and  pork  richest  in  fat ;  horse  and  veal 
poorest  in  fat ;  beef  richest  in  extractives ;  veal  poorest  in  extractives. 

All  of  which  explains  the  superior  nutritive  value  of  game  and  wild 
fowl,  in  the  so-called  dark  meats  and  also  the  superior  flavor  of  beef 
and  fowl  over  veal  and  pork,  and  also  explains  the  rich  amount  of 
gelatin  in  veal  broth  and  gravies. 


128  BEPOETS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

The  particular  part  from  which  the  meat  is  derived  also  influences 
the  percentage  of  proteids,  as  shown  by  Konig ; 

Per  cent  of  proteids  in  beef  from — 

A  shoulder  piece 14.  50 

The  loins 18.  80 

The  neck 19.  50 

The  hind  quarter 20.81 

The  meat  of  young  animals,  on  account  of  the  excess  of  water,  con- 
tains less  nutriment,  but  because  of  the  more  delicate  connective  tissue 
is  more  readily  digested. 

FISH. 

The  meat  of  fish  contains  about  the  same  foodstuffs,  only  in  smaller 
proportions,  due  to  the  excess  of  water.  Most  of  the  fish  meat  con- 
tains from  15  to  20  per  cent  of  proteids,  but  oysters,  crabs,  and 
lobsters  contain  only  from  5  to  10  per  cent.  There  is  little  or  no 
difference  in  the  digestibility  of  white  and  dark  meats,  as  from  95  to 
96  per  cent  are  utilized.  Fish  meat,  contrary  to  popular  opinion, 
contains  less  phosphates  than  that  of  other  animals. 


Carbo- 
hydrates. 


Oysters 

Canned  oysters.. 

Clams 

Mussels 

Lobsters 

Crab 

Shrlmj)s,  canned 

Terrapin 

Green  turtle 


Proteids. 

Fats. 

Salts. 

Per  cent. 

Per  cent. 

Per  cent. 

9.78 

2.05 

1.98 

7.41 

2.07 

2.15 

14.55 

1.79 

2.76 

12. 51 

1.67 

1.73 

14.49 

1.84 

1.71 

16.64 

1.96 

3.13 

25.38 

1.00 

2.58 

21.23 

3.47 

1.02 

19.84 

.53 

1.20 

Per  cent. 
5.89 
3.95 
2.94 
5.42 


According  to  J.  Konig  and  the  United  States  Commissioner  of 
Fisheries  the  composition  of  fish  meat  is  as  follows : 


» 

Haddock 

Pike 

Carp 

Herring 

Eel 

Salmon 

Shad 

Spanish  mackerel 

Mackerel 

Lake  trout 

Brook  trout 

Halibut 

Black  bass 

Red  bass 

White  perch 

Yellow  perch 

Red  snapper 

Sturgeon 

Smelt 

Codfish  meal 

Smoked  haddock 

Smoked  herring 


Proteids. 

Fats. 

Percent. 

Per  cent. 

16.71 

0.20 

18.34 

.51 

21.86 

1.09 

10.11 

7.11 

12.83 

28.37 

15.01 

6.42 

18.65 

9.48 

20.97 

9.43 

18.77 

8.21 

18.22 

n.88 

18.97 

2.10 

18.35 

6.18 

21.05 

2.44 

16.68 

.53 

19.03 

4.07 

18.49 

.70 

19.20 

1.03 

17.96 

L90 

17.36 

1.80 

74.46 

LOO 

33.68 

.17 

36.44 

15.82 

Salts. 


Per  cent. 
L44 

.93 
1.33 
2.07 

.81 
1.36 
L36 
1.60 
L40 
1.26 
L21 
1.06 
1.24 
1.23 
1.19 
1.29 
L31 
1.43 
1.68 
6.41 
1.63 
2.06 


The  consumption  of  raw  meats  should  be  discouraged  on  account 
of  the  danger  of  transmission  of  animal  parasites  which  are  only 
destroyed  by  a  temperature  of  1G0°  F. 

In  roast iig  meat,  certain  chemical  changes  take  place  which  not 
only  improve  the  taste  but  its  digestibility,  largely  because  the  ccn- 


EEPOBTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  129 

nective  tissue  is  converted  into  gelatin  and  the  liberated  muscular 
fibers  are  more  readily  acted  upon  by  the  digestive  fluids. 

Broiling  produces  very  much  the  same  changes,  except  perhaps  a 
more  complete  retention  of  the  juices,  extractives,  and  salts.  Fried 
meats  are  usually  objectionable,  unless  they  have  been  dropped  into 
very  hot  fat,  in  which  case  coagulation  of  the  albumin  not  only  pre- 
vents excessive  absorption  of  fat,  but  also  the  exudations  of  flavor 
and  juices. 

BOILED    MEATS    AND   BEOTHS. 

Boiling  water  coagulates  the  albumin,  transforms  the  connective 
tissue  into  gelatin,  and  dissipates  the  coloring  matter,  but  as  the 
water  penetrates,  it  abstracts  some  of  the  newly  formed  gelatin,  ex- 
tractives, and  salts ;  also  some  of  the  fats  and  proteids.  The  loss  thus 
sustained  depends  upon  whether  the  meat  has  been  placed  in  boiling 
or  cold  water.  If  we  wish  to  retain  the  juices  and  flavor  in  the  meat, 
it  should  be  plunged  in  boiling  water,  as  the  rapid  coagulation  of 
the  albumin  will  prevent  excessive  exudation.  If,  on  the  other  hand, 
we  desire  a  rich  broth,  the  meat  should  be  placed  in  cold  water  and 
kept  at  a  temperature  below  160°.  The  loss  sustained  in  extractives, 
salts,  and  water  renders  boiled  meat  less  palatable  and  also  some- 
what tougher  unless  cooked  at  a  temperature  below  180°,  and  it  is 
therefore  not  so  easily  digested;  the  nutritive  value  of  boiled  meat, 
however,  is  not  impaired  and  the  objections  referred  to  can  be  over- 
come by  chopping  and  the  addition  of  spices. 

In  stewing,  the  meat  should  be  cut  into  small  pieces,  placed  in  cold 
water,  and  brought  up  gradually  to  a  temperature  of  180  degrees,  and 
kept  there  for  several  hours. 

Gravies,  on  account  of  the  large  amount  of  fat  and  gelatin  present, 
are  liable  to  cause  indigestion  in  feeble  stomachs  and  are  not  suitable 
for  the  sick  and  invalids. 

The  meat  peptones  and  meat  juices,  because  of  the  presence  of  pro- 
teids, are  doubtless  of  value  in  the  treatment  of  disease. 

SPECIAL  CONCENTRATED   MEAT  PBODUCTS. 

Meat  powder  or  meat  flour  is  made  of  lean  beef,  cut  into  strips  and 
dipped  into  very  hot  fat.  After  draining,  it  is  dried  slowly  in  an 
oven  and  ground  into  very  fine  powder,  1  pound  representing  about 
4  pounds  of  flesh.  The  nutritive  value  of  these  products  is  very  high. 
Carne  pura  contains  68  per  cent  of  protein,  and  codfish  meal  Y9  per 
cent.  Their  digestibility  is  also  very  good,  they  keep  well,  and  the 
price  is  moderate,  but  on  account  of  their  taste  and  odor  they  have 
not  come  into  general  use.  Meat  powder  has  been  mixed  with  meal 
from  the  legumes,  wheat  flour,  and  other  farinaceous  food  in  the  form 
of  biscuits  or  compressed  cakes  for  use  as  an  army  emergency  ration. 
The  nutritive  value  of  ham,  bacon,  sausage,  and  other  meat  products 
is  also  very  high. 

Meat  may  be  preserved  by  cold  storage,  by  heat  as  in  the  canning 
process,  by  drying  as  in  the  case  of  jerked  beef  or  venison,  by  smoking 
and  pickling  either  in  brine  or  vinegar.  Chemical  preservatives 
other  than  salt  or  vinegar  should  not  be  tolerated,  as  we  possess  in 
cold  storage  and  heat  far  more  efficient  and  certainly  less  harmful 
preservatives. 

S.  Doc.  644,  60-2 10 


130  EEPORTS   OP   THE  PRESIDENT'S   HOMES  COMMISSION. 


MEAT   INSPECTION. 


In  judging  the  quality  and  wholesomeness  of  meat,  the  color,  con- 
sistency, and  odor  are  valuable  points  to  be  observed.  Good  beef  has 
a  bright  red  color  and  marbled  appearance  due  to  the  presence  of 
fat;  it  is  firm  yet  elastic  to  the  touch,  moderately  moist,  and  has  a 
characteristic  beefy  odor.  Bull  beef  is  usually  of  a  darker  color; 
mutton  has  more  of  a  brownish  red  color;  meat  of  immature  animals 
is  pale,  watery,  and  friable.  Meat  which  has  gone  beyond  the  first 
stage  of  decomposition  is  soft  and  liable  to  pit  or  crackle  upon  pres- 
sure, and  emits  an  offensive  tainted  odor,  especially  when  hot  water 
is  poured  upon  it.  In  pushing  a  knife  to  the  hilt,  the  resistance  in 
good  meat  is  uniform,  while  in  putrefying  meat  some  parts  are  softer 
than  others  and  the  tainted  odor  clings  to  the  knife.  In  temperate 
climates  the  marrow  remains  solid  for  twenty-four  hours  and  is  of  a 
light  pink  color;  when  it  is  soft,  looks  brownish,  and  contains  black 
points  the  animal  has  either  been  sick  or  putrefactive  changes  have 
begun. 

In  connection  with  meat  products  the  possibility  of  ptomaine 
poisoning,  with  symptoms  of  nauseau,  vomiting,  diarrhea,  cramps, 
and  depression  should  not  be  overlooked.  Similar  symptoms  have 
been  observed  after  the  eating  of  oysters,  mussels,  crabs,  lobsters,  and 
milk.  Oysters  raised  in  sewage-polluted  beds  have  been  known  to 
transmit  the  germs  of  typhoid  fever.  Diseases  like  anthrax,  bovine 
tuberculosis,  hydrophobia,  foot-and-mouth  disease,  infectious  en- 
teritis, actinomyces,  trichina,  and  cystererci  are  transmissible  to  man 
through  the  meat  supply.  For  all  these  reasons  hygiene  demands 
not  only  a  proper  control  of  the  meat  market,  but  also  proper  cook- 
ing, since  nothing  short  of  a  temperature  of  160°  wdll  destroy  these 
organisms. 

MILK. 

Milk  is  an  ideal  food.  The  average  composition  of  cow's  milk  is 
protein,  4.5 ;  fat,  3 ;  sugar,  4.5 ;  salts,  0.75 ;  water,  8T.25. 

In  keeping  milk  at  ordinary  temperature  it  rapidly  undergoes 
changes  which  are  brought  about  by  the  agency  of  micro-organisms. 
One  of  the  greatest  dangers  in  milk  is  caused  by  impurities  seen  in 
the  so-called  milk  sediments,  which  consist  largely  of  excrementi- 
tious  matter  clinging  to  the  teats  and  udder  of  the  animal,  and  which, 
owing  to  the  presence  of  fecal  bacteria,  bring  about  rapid  souring 
of  the  milk,  with  the  production  of  toxins  such  as  tyrotoxicon,  and 
these  in  turn  give  rise  to  cholera  infantum  and  other  gastro-enteric 
diseases. 

The  reaction  of  milk  should  be  neutral  or  amphoteric,  the  amount 
of  cream  should  not  be  less  than  10  per  cent  per  volume,  and  the 
amount  of  total  solids  not  less  than  12  per  cent,  of  which  at  least  3 
per  cent  should  be  butter  fat.  Milk  is  not  quite  as  digestible  as  meat; 
nevertheless,  from  89  to  92  per  cent  is  utilized.  Boiled  milk  is  not  as 
digestible  as  raw  or  pasteurized  milk.  (See  also  milk  as  a  cause  of 
disease,  p.  193. 

Skimmed  milk  is  the  residue  after  the  cream  has  been  removed. 
As  it  contains  the  other  solids  and  is  quite  cheap,  it  should  become  a 
more  popular  article  of  food.    The  same  may  be  said  of  cott^ige  cheese. 

There  are  a  number  of  brands  of  condensed  milk  in  the  market,  all 
made  by  the  evaporation  of  the  water  of  the  milk  by  moderate  heat  or 


REPORTS    OF    THE  PRESIDENT'S  HOMES   COMMISSION.  131 

in  vacuum  pans  with  or  without  the  addition  of  sugar.  In  the  plain 
variety  the  milk  is  condensed  to  about  one-third  or  one-fourth  of  its 
volume.  As  at  present  prepared,  condensed  milk  is  unsuitable  for 
infant  feeding,  because  it  contains  an  excess  of  the  proteids  and  sugar 
and  is  deficient  in  fats.  These  objections  can  be  removed  by  modify- 
ing the  milk  previous  to  condensation,  so  that  the  composition  is  as 
nearly  as  possible  that  of  human  milk.  It  then  can  be  condensed  to 
about  one-third  of  its  original  volume  and  the  proportions  restored 
by  proper  dilution  just  before  using  it  for  infant  feeding. 

Whey  is  the  serum  or  watery  part  of  the  milk  which  remains  after 
the  curds  have  been  pressed  out  from  the  milk  to  make  cheese.  It  is 
used  in  certain  diseases  and  also  as  a  food  in  very  difficult  cases  of 
indigestion  in  infant  feeding. 

Milk  wines,  like  koumis  and  kefyr,  are  made  from  mares'  or  cows' 
milk,  respectively,  and  are  the  products  of  a  peculiar  fermentation, 
combining  alcoholic  with  lactic  acid  fermentations.  These  beverages, 
in  addition  to  the  normal  constituents  of  milk,  contain  alcohol,  car- 
bonic acid,  and  lactic  acid,  and  are  of  value  in  the  feeding  of  invalids. 

Buttermilk  contains  all  of  the  constituents  of  milk  except  that  the 
amount  of  fat  and  sugar  is  less.  The  presence  of  lactic  acid  imparts 
a  pleasant  taste,  and  as  it  contains  most  of  the  desirable  nutrients  and 
is,  moreover,  quite  cheap,  its  use  should  be  encouraged. 

CHEESE. 

Cheese  varies  in  richness  according  to  the  amount  of  cream  used  in 
its  manufacture.  Cheeses  contain  from  26  to  40  per  cent  of  fat  and  17 
to  29  per  cent  of  protein,  and  possess,  therefore,  remarkable  nutritive 
qualities.  If  taken  in  reasonable  quantities,  96  per  cent  of  the  protein 
and  97  per  cent  of  the  fat  is  digested.  Cheese  should  never  be  taken  in 
the  form  of  toasted  cheese.  The  richer  cheeses,  unless  eaten  quite 
sparingly,  are  very  apt  to  produce  dyspepsia. 

BUTTEE  AND  BUTTEB  SUBSTITUTES. 

Butter  is  formed  by  churning  the  cream  of  milk.  The  amount  of 
butter  in  coavs'  milk  is  about  3.75  or  4  per  cent  (i.  e.,  about  4  pounds 
to  the  100  pounds  of  milk).  Butter  contains  about  84  per  cent  of  fat, 
of  which  nearly  97  per  cent  is  digested  if  taken  in  moderate  quanti- 
ties.    Eancid  butter  is  very  liable  to  cause  indigestion. 

Process  or  renovated  butter  is  the  product  of  rancid  or  tainted  but- 
ter which  has  been  purified  by  melting  and  washing,  and,  since  it  is 
sold  far  below  the  market  value  of  butter  and  possesses  the  same  nutri- 
tive properties  as  fresh  butter,  its  use  should  not  be  scorned. 

Oleomargarine  is  a  mixture  of  oleo  oil  derived  from  the  richest 
and  choicest  fat  of  the  beef,  neutral  lard,  butter,  cream,  or  milk  and 
salt,  and  in  the  cheaper  grades  cotton- seed  oil  is  also  used.  Oleo  and 
neutral  lard  are  the  chief  ingredients.  These,  after  melting,  are 
churned  with  cream  or  milk,  salted,  and  run  through  cold  water, 
worked  in  a  butter  worker,  and  placed  in  suitable  packages  and 
labeled,  according  to  the  United  States  laws,  "  Oleomargarine."  If 
colored  to  resemble  June  butter  it  is  subject  to  a  special  tax  of  10  cents 
per  pound.  If  sold  uncolored  the  revenue  tax  is  only  one-fourth  cent 
per  pound.    There  is  practically  no  difference  in  the  nutritive  value 


132 


REPORTS   OF   THE   PRESIDENT  S   HOMES   COMMISSION. 


and  the  digestibility  between  butter  and  oleomargarine  or  butterine, 
and,  as  it  is  sold  for  half  the  cost  of  butter,  the  writer,  as  a  teacher 
of  hygiene,  has  urged  upon  his  students  for  years  to  bring  the  nutri- 
tive value  of  this  foodstuff  to  the  attention  of  the  public  and,  in  the 
interest  of  the  wage-earners,  to  correct,  as  far  as  possible,  the  preju- 
dice which  has  been  created  against  its  use,  provided,  of  course,  it  is 
sold  under  its  true  name  and  at  its  real  value. 


EGGS. 


Egg  albumin  has  the  following  composition :  Albumin  13  per  cent, 
fat  0.2  per  cent,  salts  0.6  per  cent,  water  86  per  cent ;  yolk,  vitellin  15.8 
per  cent,  lecithin  8.7  per  cent,  nuclein  1.5  per  cent,  fat  20.3  per  cent, 
salts  1  per  cent,  water  51.8  per  cent.  Eggs,  raw  or  soft  boiled  or  when 
stirred  into  hot  soups,  are  readily  digested ;  about  97  per  cent  of  the 
proteids  and  95  per  cent  of  the  fats  are  utilized.  Hard-boiled  eggs 
are  not  readily  digested,  and  for  people  with  feeble  digestion  the  yolk 
of  the  egg  stirred  in  soup  should  be  preferred.  The  nutritive  value 
of  a  single  egg  is  equal  to  37  grams  of  fat  beef  or  165  c.  cm.  of  rich 
milk.  Fish  eggs  contain,  on  the  whole,  the  same  nutritive  principles 
as  chicken  eggs,  only  in  different  proportions. 

VEGETABLE  FOOD. 

CEEEALS. 

Of  all  the  vegetables  the  cereals  stand  at  the  head  of  the  list.  While 
the  legumes  contain  more  vegetable  albumin,  they  can  not  be  prepared 
in  so  many  suitable  ways,  and  are  more  difficult  of  digestion. 

H.  W.  Wiley's  analysis,  based  upon  American  grains,  is  as  follows : 


Wheat 

Rye 

Barley 

Oata 

Indian  corn... 
Buckwheat . . . 
Rice,  polished 


Mois- 
ture. 


Per  cent. 
10.60 
10.50 
10. 85 
10.00 
10.75 
12.00 
12.40 


Pro- 
teids. 


Per  cent. 
12.25 
12.26 
11.00 
12.00 
10.00 
10.75 
7.50 


Fat  and 

ether 
extracts. 


Per  cent. 
1.75 
1.50 
2.25 
4.50 
4.25 
2.00 
.40 


Starch. 


Per  cent. 
71.25 
71.75 
69.55 
58.00 
71.75 
62. 75 
78.80 


Cellu- 
lose. 


Per  cent. 
2.40 
2.10 
3.85 
12.00 
1.75 
10.75 
.40 


Salts. 


Per  cent. 
1.75 
1.90 
2.50 
3.50 
1.50 
1.75 
.50 


The  following  table  (ITffelmann's)  shows  the  average  composition 
of  different  flours  and  cereals: 


Pro- 
tein. 

Cnrbo-   |    Cellu- 
hydratcs.      lose. 

Fine  wheat  flour 

Per  cent. 
11.00 
10.20 
10.43 
10.89 
11. 25 
14.29 
10.00 
10.71 
7.80 

Per  cent. 
74.90 
7.'i.l0 
75.95 
71.85 
70.64 
65.73 
71.00 
70.12 
79.40 

Per  cent. 

Pine  rye  flour 

Fine  cracked  wheat 

0  22 

Fine  cracked  barlev 

47 

Pealed  barley 

54 

Oatmeal 

2  24 

Commeal 

2  50 

Buckwheat  meul _ 

1  04 

Rice 

EEPORTS   OF   THE  PKESIDENT  S  HOMES  COMMISSION. 


133 


The  cereals  are  eaten  only  after  a  series  of  careful  manipulations 
producing  different  grades  of  flour,  varieties  of  breakfast  cereals,  etc. 
In  the  finest  grades  of  flour  nearly  all  the  outer  membranes  of  the 
wheat  grain  (bran)  is  separated;  while  this  removes  much  indigesti- 
ble matter  it  also  removes  some  of  the  proteids  and  fats.  On  the  other 
hand  the  nutritive  material  in  bran  is  in  a  form  quite  difficult  of 
digestion,  and  the  experiments  conducted  by  Professor  Snyder  in  1901 
indicated  that  the  available  proteids  in  graham  bread  are  not  utilized 
to  the  same  extent  as  in  high-grade  white  bread. 

Wlieat  and  rye  flour,  on  account  of  the  gluten  present,  are  especially 
suited  for  the  preparation  of  bread;  preference  should  be  given  to 
properly  baked  yeast  bread,  and  next  to  the  patent  aerated  bread, 
while  the  use  of  baking  powders  should  be  discouraged.  Apart  from 
the  fact  that  yeast  predigests  in  a  degree  the  starchy  matter,  baking 
powders  are  often  subject  to  shameful  adulterations.  Bread  possesses 
decided  nutritive  qualities,  the  proportion  of  nitrogenous  to  non- 
nitrogenous  matter  being  1  in  7.  Experience  has  shown  that  a  male 
adult  can  not  digest  over  750  grams,  and  a  female  over  600  grams  a 
day.  This  amount  would  supply  about  two-fifths  of  the  protein  and 
two-thirds  of  the  carbohydrates  required  in  twenty-four  hours. 
When  taken  in  proper  quantities  95  to  96  per  cent  of  a  light,  spongy 
bread  are  digested.  Toasted  bread  contains  less  water  and  hence  more 
nutriment  pound  for  pound.  Crackers  can  not  take  the  place  of 
bread.  Gluten  crackers  are  suitable  for  diabetic  subjects,  because  they 
contain  from  55  to  75  per  cent  of  protein  and  only  from  10  to  30  per 
cent  of  starch. 

The  nutritive  value  of  vermicelli,  macaroni,  and  the  various  grits 
used  in  soups  and  in  the  preparation  of  mushes  may  be  materially 
enhanced  by  the  addition  of  milk  and  cream. 

Legumes  are  a  most  valuable  class  of  foodstuff,  on  account  of  the 
great  amount  of  vegetable  albumin  present,  and  have  very  aptly  been 
called  the  poor  man's  meat.-  The  difference  in  nutritive  value  be- 
tween the  immature  peas  and  beans,  which  are  used  as  green  vegeta- 
bles, and  the  matured  seeds  is  shown  by  the  analysis  of  Konig, 
Atwater,  and  Bryant : 


Pro- 
teids. 

Fat. 

Starch 

and 
dextrin. 

Carbohy- 
drates. 

Cellu- 
lose. 

Salts. 

Soja  beans 

Per  cent. 
33.41 
24. 27 
23.21 
22.85 
26.70 
7.00 
3.60 

2.30 
1.10 

Per  cent. 
17.19 
1.61 
2.14 
1.79 
1.89 
•   .50 
.20 

.30 
.10 

Per  cent. 
29.99 
49.01 
53.67 
52.46 
53.46 

Per  cent. 

Per  cent. 
4.71 
7.09 
3.69 
5.43 
3.57 

Per  cent. 
5.19 
3.26 
3.56 
2.58 
3.04 
1  00 

Kidney  beans 

Peas 

Lentils 

Green  peas  (Atwater  and  Brvant) 

16.90 
9.80 

7.40 
3.80 

Canned  peas  (Atwater  and  Bryant) 

1  10 

String  beans: 

Fresh 

80 

Canned 

1  30 

The  digestibility  of  these  vegetables  depends  largely  upon  the 
rnode  of  cooking;  they  should  not  be  cooked  in  hard  water,  as  the 
lime  salts  form  insoluble  compounds  with  the  legumin,  and  after 
cooking  the  outer  membrane  should  be  removed  by  straining,  in 
which  case  about  88  per  cent  of  the  nutritives  are  utilized.  If  they 
are  old  they  should  first  be  soaked  for  twenty-four  hours  in  cold 
water. 


134 


REPORTS  OF   THE  PRESIDENT  S  HOMES  COMMISSION. 


SUCCULENT   VEGETABLES. 


Almost  all  of  the  fresh  vegetables,  except  potatoes  and  green  peas, 
contain  a  great  amount  of  water,  cellulose,  and  salts,  and  therefore 
very  little  nutriment.  They  are  rich  in  amido-compounds,  and  their 
chief  value  consists  in  the  fact  that  they  supply  the  mineral  salts  in 
a  very  palatable  and  assimilable  form. 

Potatoes  contain  proteids  2  per  cent,  fat  0.10  per  cent,  starch  20 
per  cent.  The  juice  is  a  valuable  antiscorbutic.  If  over  600  grams  of 
potatoes  are  taken  daily  some  of  the  starch  is  liable  to  undergo  fer- 
mentation. In  sprouting  solanin,  a  toxic  agent,  is  produced ;  this  is 
liable  to  cause  nausea,  vomiting,  and  diarrhea.  The  nutritive  value 
of  potatoes  can  be  improved  by  cooking  them  in  their  jackets  and  the 
addition  of  butter  and  milk;  fried  potatoes,  except  in  the  form  of 
Saratoga  chips,  can  not  be  recommended. 

String  beans  and  green  peas  possess  greater  nutritive  value  than 
potatoes,  carrots,  beets,  oyster  plant,  parsnips,  radishes,  turnips, 
pumpkins,  celery,  lettuce,  squash,  asparagus,  tomatoes,  and  cucum- 
bers on  account  of  the  greater  amount  of  vegetable  albumin  present. 
With  the  exception  of  beans  and  peas  most  of  the  vegetables  are 
deficient  in  proteids  but  fairly  rich  in  carbohydrates  and  are  chiefly 
valuable  for  their  salts  and  for  the  variety  which  they  give  to  our 
food. 

The  different  varieties  of  cabbage  and  spinach  are  antiscorbutic 
agents,  while  lettuce  and  endive  owe  their  refreshing  taste  to  the 
presence  of  organic  acids  in  the  form  of  citrates,  malates,  and  oxa- 
lates. The  efficacy  of  onions,  wild  artichoke,  sorrel,  scurvy  grass, 
mustard,  cress,  and  lambs'  quarters  as  antiscorbutics  should  not  be 
forgotten.  The  nutritive  value  of  edible  mushrooms  is  not  greater 
than  that  of  other  fresh  vegetables;  they  are  not  easily  digested  and 
have  been  greatly  overrated  as  an  article  of  diet. 


FRUITS. 


Fruits,  apart  from  vegetable  fiber  and  juice,  contain  some  soluble 
proteids,  sugar,  dextrose,  lavulose,  pectins,  free  organic  acids  (citric, 
malic,  and  tartaric),  and  compounds  of  these  with  potassium,  sodium, 
and  lime.  The  quantitative  composition  of  some  of  the  fresh  fruits, 
according  to  Konig,  is  as  follows : 


Qrapes 

Cherries 

Peaches 

Pears 

Apples 

Apricots 

Plums 

Currants 

Strawberries. . 

Oranges 

Blackberries. . 
RaspbcrricH... 
Cranberries... 
Huckleberries 
Dried  grapes . 
Dried  apples.. 
Dried  pears... 
"  plozoB. . 


Proteids. 


Per  cent. 

0.59 

.67 

.65 

.36 


.78 

.61 

.54 

.73 

.51 

.40 

.12 

.78 

2.42 

1.28 

2.07 

2.25 


Free 
acids. 


Per 


cent. 

0.79 

.91 

.92 

.20 

.82 

1.16 

.85 

2.16 

.93 

2.44 

1.19 

1.42 

2.34 

L66 


3.60 

.84 

2.75 


Sugar 

and 

pectin. 


Per  cent. 

26. 32 

12.00 

11.65 

11.90 

13.03 

11.04 

11.07 

7.28 

7.74 

5.54 

4.44 

3.86 

1.53 

5.02 

62.00 

59. 77 

58.80 

62.32 


Cellu- 
lose. 


Per  cent. 
3.60 
6.07 
6.06 
4.30 
1.51 
6.27 
5.41 
4.67 
2.32 
1.79 
6.97 
8.10 
6.27 
13.16 


4.99 
6.86 
1.62 


Salts. 


Per  cent. 

0.53 

.73 

.69 

.31 

49 

82 

.71 

.72 

.81 

.49 

.48 

.48 

.16 

1.02 

1.21 

1.57 

1.67 

1.87 


REPORTS   OP   THE  PRESIDENT  S  HOMES  COMMISSION. 


135 


Watermelons  contain  92  per  cent  of  water,  0.4  per  cent  of  protein, 
0.2  per  cent  fat,  6.7  per  cent  of  carbohydrates  and  fiber,  and  0.3  per 
cent  of  salts.  There  is  nothing  in  their  nutritive  qualities  to  justify 
their  popularity.  Ripe  bananas  contain  20  per  cent  of  sugar,  2  per 
cent  of  protein,  0.5  per  cent  of  starch,  and  a  little  more  of  fat.  Fresh 
figs  are  about  equal  in  nutritive  value  to  the  banana.  The  dried  fig 
contains  50  per  cent  of  sugar,  4  per  cent  of  protein,  3  per  cent  of  salts, 
and  about  13  per  cent  of  seeds  and  indigestible  fiber. 

Fruit  contains  very  little  protein,  but  the  percentage  of  carbohy- 
drates is  considerable,  and  on  account  of  the  organic  salts  and  aro- 
matics  they  are  very  refreshing  and  promote  the  action  of  the  bowels 
and  kidneys.  Hard  and  very  acid  fruits  are  liable  to  produce  diar- 
rhea. Lemon  and  lime  juice  contain  free  organic  acids,  about  30 
grains  of  citric  acid  to  1  ounce  of  the  juice,  and  are  excellent  anti- 
scorbutic agents. 

Shell  fruits  contain  a  great  amount  of  nutritive  material  in  the 
form  of  protein,  fat,  and  carbohydrates,  as  shown  by  the  following 
table  prepared  by  Uffelmann : 


Protein. 

Fat. 

Carbo- 
hydrate. 

Cellu- 
lose. 

Salts. 

Almonds 

Per  cent. 
24.18 
16.37 
5.48 
3.99 

Per  cent. 

53.68 

62. 86 

1.37 

1.69 

Per  cent. 

7.23 

7.89 

38.34 

67.67 

Per  cent. 
6.56 
6.17 
1.61 
5.10 

Per  cent. 
2  96 

Walnuts 

2  03 

Chestnuts 

1.72 

Bread  fruit 

1  69 

Hazelnuts  have  about  the  same  composition  as  walnuts.  The  meat 
of  cocoanuts  contains  about  TO  per  cent  of  fat  and  the  milk  contains 
nearly  7  per  cent  of  sugar.  Peanuts  contain  about  30  per  cent  of  pro- 
tein and  45  per  cent  of  fat,  and  hence  enjoy  a  very  deserved  reputa- 
tion. Chestnuts  are  quite  indigestible  in  the  raw  state,  and  should 
be  either  roasted  or  cooked.  Roasting  also  aids  in  the  digestion  of 
peanuts  and  almonds. 

Honey,  sugar,  and  sirups  are  foodstuffs,  as  they  supply  heat  and 
energy  in  the  system  and  also  improve  the  palatability  of  the  food. 
The  same  is  true  of  jams  and  jellies;  the  latter  delicacies  should 
always  be  homemade,  as  it  is  frequently  the  case  that  they  are  made 
from  glucose,  sirups,  and  gelatin  artificially  colored  and  flavored. 
Indeed  it  has  been  shown  that  the  refuse  of  fruit-canning  establish- 
ments and  such  tasteless  articles  as  summer  squash,  boiled  white  tur- 
nips, and  clover  seed  are  transformed  into  commercial  jams. 

COMBINATION  OF  FOOD. 

A  question  of  considerable  importance  is  whether  the  needs  of  the 
economy  shall  be  supplied  with  an  animal,  vegetable,  or  mixed  diet, 
and  the  answer  is  plainly  in  favor  of  a  mixed  course.  In  the  first 
place,  the  structures  of  our  teeth  and  digestive  tract  plainly  indicate 
that  we  occupy  an  intermediate  position  between  the  carnivora  and 
herbivora.  In  the  second  place,  if  we  were  to  supply  the  needs  of 
protein  in  the  system  exclusively  from  the  vegetable  kingdom,  we 
would  have  to  introduce  an  excess  of  carbohydrates,  i.  e.,  about  1,800 
grams  of  bread  or  rice  or  6,000  grams  of  potatoes.  On  the  other 
hand,  in  order  to  supply  the  requirements  of  carbon  from  the  animal 
kingdom,  we  woul^  have  to  eat  about  7,000  grams  of  meat  containing 


136  REPORTS   OF    THE   PRESIDENT'S   HOMES   COMMISSION. 

5  per  cent  of  fat  or  drink  6,000  grams  of  milk.  Such  quantities  can 
not  be  taken  for  any  length  of  time  without  creating  intense  disgust 
for  food  and  causing  serious  systemic  disorders.  For  these  reasons 
alone  a  mixed  diet  should  be  preferred.  Moreover,  Uffelmann  has 
shown  that  the  recruits  of  a  Prussian  infantry  company,  between  the 
ages  of  21  and  22  years,  made  their  best  gains  while  subsisting  on 
39  grams  of  animal  and  71  grams  of  vegetable  proteids,  and  con- 
cludes that  this  proportion  is,  physiologically  speaking,  the  proper 
one.  Indeed  an  exclusive  animal  diet  is  liable  to  produce  gout  and 
diseases  of  the  arteries,  kidneys,  and  liver,  and  health  suffers  when- 
ever 75  per  cent  or  more  of  the  proteids  are  supplied  in  the  form  of 
meat  or  eggs,  probably  on  account  of  the  crystalline  waste  products 
in  the  blood. 

Food  should  be  combined  so  as  not  to  tax  the  digestive  organs. 
Thus,  for  example,  milk  is  not  well  borne  with  acid  fruits,  and  the 
digestibility  of  eggs  is  impaired  by  large  quantities  of  fluids.  The 
condiments  and  relishes  should  not  be  wanting,  and  monotony  in  diet 
should  be  avoided.  The  foundation  of  a  suitable  diet  will,  however, 
be  found  in  meat,  milk,  butter  or  fat,  bread,  rice,  or  potatoes. 

The  amount  of  cooked  meat  should  not  be  less  than  160  grams  and 
should  not  exceed  190  grams  a  day,  or  from  180  to  210  grams  of  fish. 
If  the  minimum  amounts  are  taken,  the  deficiency  should  be  supplied 
by  250  c.  cm.  of  milk. 

The  daily  requirements  of  fat  are  at  least  25  grams  of  butter,  oleo- 
margarine or  lard,  or  30  grams  of  bacon,  according  to  the  taste  and 
circumstances  of  the  individual. 

Bread  is  an  indispensable  article  of  diet,  and  has  long  been  called 
the  staff  of  life;  it  furnishes  a  well-balanced  ration  of  protein  and 
hydrocarbons,  but  experience  has  shown  that  more  than  750  grams 

Eer  day  can  not  be  tolerated,  nor  can  more  than  600  grams  of  potatoes 
e  profitably  consumed  per  day.     It  is  very  desirable  that  legumes 
and  rice  should  take  the  place  of  some  of  the  potatoes. 

From  our  knowledge  of  the  proximate  constituents  contained  in 
the  various  foodstuffs,  diet  tables  can  be  constructed  which  will  meet 
the  requirements  of  the  body  as  well  as  the  purse  of  the  consumer. 
So,  for  example,  a  ration  of  bread,  codfish,  lard,  bacon,  potatoes, 
beans,  milk,  sugar,  and  tea  may  be  purchased  for  15  to  20  cents  which 
in  actual  food  value  is  equal  to  the  best  hotel  fare. 

STOREROOMS  AND  PANTRIES. 

The  different  methods  employed  in  food  preservation — such  as  cold 
storage,  drying,  salting,  pickling,  and  canning — have  been  briefly  re- 
ferred to,  and  it  remains  to  point  out  what  may  be  done  for  the  preser- 
vation of  food  of  a  perishable  nature.  When  we  realize  that  all  fer- 
mentative and  putrefactive  processes  are  initiated  by  micro-organ- 
isms, we  will  appreciate  the  importance  of  absolute  cleanliness  and 
the  creation  of  such  environments  as  will  preclude  at  least  their  rapid 
proliferation.  For  this  purpose  the  food  should  be  kept  in  dry,  well- 
ventilated,  and  cool  storerooms  or  pantries,  located  preferably  in  the 
basement,  and  away  from  contaminating  influences,  such  as  impure 
air,  dust,  and  other  sources  of  infection.  In  summer  the  use  of  ice 
boxes  or  cold  storage  is  quite  essential  to  inhibit  bacteria  1  develop- 
ment, and  food  should  be  purchased  in  such  quantities  ns  to  insure 
speedy  consumption.     It  is  perhaps  unnecessary  to  say  that  food 


REPORTS    OF    THE   PRESIDENT'S   HOMES   COMMISSION.  137 

should  never  be  kept  in,  or  in  close  proximity  to,  living  and  sleeping 
rooms  or  soiled  linen  closets,  and  yet  this  is  not  infrequently  the  case. 
In  order  to  prevent  infection  of  the  food  by  means  of  flies,  the  store- 
room should  be  properly  screened,  and  it  is  also  a  good  plan  to  use 
either  filtered  or  boiled  water  for  washing  fruits  and  vegetables  which 
are  eaten  raw.  Persons  suffering  or  recovering  from  communicable 
diseases  should  not  be  permitted  to  handle  food  for  others.  Food 
should  never  be  placed  in  dirty  pans  or  dishes,  and  great  care  should 
be  exercised  to  prevent  metallic  contamination.  For  example,  old 
milk  pans  may  impart  zinc,  utensils  made  of  tin,  lead,  or  copper  may 
contaminate  fruit,  lead  or  tinfoil  may  contaminate  cheese;  arsenical 
pigments  have  been  knowm  to  contaminate  the  bread  in  green-painted 
bread  boxes,  or  confectionery  wrapped  in  colored  papers. 

PREPARATION  OF  FOOD  FOR  COOKING,  ETC. 

Prior  to  coolring,  all  raw  materials  should  be  thoroughly  cleaned  by 
soaking,  rubbing,  rinsing,  and  wiping.  This  will  render  the  food  not 
only  more  appetizing,  but  also  more  wholesome,  by  the  removal  of 
adherent  particles  of  dirt  and  micro-organisms.  The  same  may  be 
said  of  the  removal  of  decayed  or  indigestible  portions — such  as  the 
husks  of  legumes,  the  peelings  of  fruits,  potatoes,  and  other  vege- 
tables— and  the  removal  of  tendons  and  fasciae  from  meat.  Chopping, 
grinding,  and  pounding  render  meat  and  other  articles  more  tender 
and  accessible  to  the  action  of  the  digestive  fluids.  The  addition  of 
condiments  improves  the  taste  and  digestibility,  provided  the  food  is 
not  too  highly  seasoned.  A  high  temperature  secured  by  boiling, 
steaming,  roasting,  or  baking  not  only  influences  the  consistency, 
taste,  flavor,  chemical  constitution,  digestibility,  and  keeping  qualities 
of  food,  but  also  destroys  all  parasites  and  micro-organisms  which 
may  be  present. 

COOKING  AND  EATING  UTENSILS. 

Hygiene  demands  that  all  such  utensils  must  be  kept  scrupulously 
clean;  apart  from  the  hygienic  and  esthetic  aspect,  food  served  in 
clean  and  attractive  dishes  tastes  better  and  stimulates  the  appetite 
and  digestion. 

We  have  learned  that,  long  before  we  knew  of  the  existence  of 
saprophytic  germs  and  ptomaine  intoxications,  the  Hebrews  paid 
special  attention  to  the  subject  of  clean  cooking,  eating,  and  drinking 
utensils.  We  know  from  daily  observation  that  unclean  methods  are 
a  fruitful  cause  of  disease.     (Industrial  Hygiene,  p.  111.) 

The  shape  of  cooking  utensils  is.  of  importance  in  the  question  of 
cleanliness ;  for  this  reason  a  flat  bottom,  with  a  quarter-round  termi- 
nation of  the  sides,  should  be  chosen.  Earthenware  pots  and  pans 
glazed  with  lead,  or  iron  pots  enameled  with  lead  or  zinc  containing 
lead,  should  not  be  used.  Britannia  ware  occasionally  contains  lead 
and  should  be  tested.  Utensils  made  of  nickel  impart  a  peculiar  bit- 
ter taste  to  the  food  and  drink,  but  are  not  otherwise  objectionable. 
Copper  and  brass  utensils  must  be  kept  polished  to  prevent  the  forma- 
tion of  copper  salts.  Food  containing  fat,  chloride  of  sodium,  and 
ammonia  compounds  should  not  be  permitted  to  cool  in  copper  uten- 
sils, as  the  copper  oxidizes  at  the  level  of  the  food  and  becomes  solu- 
ble.    Iron  utensils  impart  a  peculiar  inky  taste  and  grayish  appear- 


138  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

ance  to  food,  and  should  therefore  be  tinned  or  enameled.  For  all 
these  reasons  porcelain  lined  or  granite  ware  and  the  various  steam- 
cooking  utensils  should  be  preferred. 

The  temperature  of  food  and  drink  is  not  a  matter  of  indifference ; 
this  is  especially  seen  in  the  artificial  feeding  of  infants.  Iced  drinks 
hastily  swallowed  are  liable  to  cause  neuralgia  of  the  stomach,  dys- 
pepsia, and  even  acute  gastric  catarrh ;  cold  grapes  and  fruit  are  apt 
to  produce  colic  and  diarrhea.  The  bad  effects  of  cold  victuals  have 
been  frequently  observed  in  persons  obliged  to  eat  cold  lunches,  and 
may  be  regarded  as  a  frequent  cause  of  intemperance. 

Apart  from  the  bad  effects  of  high  and  low  temperature  upon  the 
teeth,'*  we  know  that  cold  injesta  also  impair  the  action  of  pepsin 
and  ptyalin,  which  are  most  efficient  at  about  the  body  temperature. 
Hot  food  or  drinks,  apart  from  injuring  the  mucous  membranes  of 
the  mouth  and  stomach,  also  interfere  with  the  action  of  pepsin  and 
ptyalin,  which  is  completely  arrested  at  a  temperature  of  140°  F. 
On  the  whole,  we  may  conclude  that  the  temperature  of  food  and 
drink  should  be  as  nearly  as  possible  that  of  the  body  heat,  and  this 
should  be  the  rule  for  infants.  A  temperature  of  45°  may  be  re- 
garded an  extreme  low  and  one  of  120°  an  extreme  high  temperature 
for  the  introduction  of  food. 

The  consistency  of  food  exerts  considerable  influence  upon  our  di- 
gestive organs;  coarse  and  tough  substances  are  less  susceptible  to  the 
action  of  the  digestive  fluids,  and  consequently  more  difficult  of  diges- 
tion ;  this  is  especially  true  of  many  fibrous  vegetables,  of  hard-boiled 
eggs,  and  heavy,  sodden  bread.  For  infants,  liquid  food  is  the  best 
form,  but  adults  require  a  certain  stimulus,  not  to  be  had  in  liquid 
food,  and  if  taken  for  any  length  of  time  this  is  certain  to  disagree 
and  create  disgust.  A  semisolid  food  has  also  been  objected  to  be- 
cause of  the  excess  of  water,  which  is  believed  to  lower  the  tone  of  the 
digestive  organs.  These  objections  have  been  urged  by  physicians  on 
behalf  of  prisoners,  who,  on  account  of  insufficient  exercise,  can  not 
very  well  get  rid  of  the  excess  of  water.  This  same  objection  does  not 
apply  to  persons  actively  employed,  and  for  whom  a  semisolid  food 
has  indeed  been  found  by  experience  the  best  suited  to  their  wants. 

VOLUME    OF   FOOD. 

It  is  not  sufficient  to  supply  the  required  quantity  of  food,  but  it 
should  also  be  introduced  in  such  a  volume  as  to  satisfy  the  feeling  of 
the  individual  and  the  capacity  of  the  stomach. 

From  the  results  of  experience  and  observation  we  may  conclude 
that  an  adult  of  average  weight  and  performing  ordinary  labor,  in 
order  to  satisfy  a  feeling  of  contentment,  requires  from  1,600  to  2,000 
grams  (4  to  5  pounds  of  food)  daily.  Of  this  amount  from  800  to 
1,000  grams  (2  to  2^  pounds)  should  be  taken  at  dinner.  These  fig- 
ures are  simply  suggestive,  and  as  individual  habits  play  an  impor- 
tant role  it  will  be  well  to  guard  against  a  sudden  increase  or  diminu- 
tion in  the  volume  of  food. 

MEAL  HOURS. 

The  daily  allowance  of  food  should  be  taken  in  divided  meals.  On 
account  of  the  different  habits  and  occupations  it  is  difficult  to  formu- 
late a  rule  for  all  classes.     In  a  general  way  we  may  say  that  a 

•  Kober's  Industrial  Hy^ene,  p.  119. 


REPORTS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  139 

healthy  adult  should  eat  at  least  three  times  and  not  oftener  than  five 
times  a  day.  The  most  rational  dinner  hour  for  a  man  who  begins  his 
labors  at  6  or  7  o'clock  in  the  morning  is  between  12  and  1  o'clock,  for 
he  will  then  be  in  need  of  food,  and  if  he  defers  his  principal  meal  till 
evening  he  will  be  so  tired  that  he  can  neither  enjoy  nor  fully  digest 
it.  Such  persons  should  eat  a  good  breakfast,  a  full  dinner  about 
noon,  and  a  supper  between  5  and  6  o'clock.  If  their  appetite  for  an 
early  breakfast  is  poor,  they  should  eat  a  light  lunch  about  9  o'clock 
a.  m.  and  a  similar  lunch  between  8  and  9  p.  m.  For  persons  not 
engaged  in  active  muscular  work  it  is  desirable  that  they  should  eat  a 
light  breakfast,  a  hot  lunch  at  noon,  dinner  at  5  o'clock,  and  some 
light  lunch  between  8  and  9  p.  m. 

Unfortunately,  we  possess  as  yet  no  reliable  data,  as  regards  the  re- 
quirements of  food  for  men  who,  while  leading  a  sedentary  life,  per- 
form a  great  amount  of  brain  woi'k.  Some  authorities  claim  that 
mental,  like  physical,  labor  increases  the  amount  of  carbon  consump- 
tion, but  not  of  nitrogen.  Others  insist  that  since  the  brain  and 
nerve  tissues  contain  the  elements  of  nitrogen  and  phosphorus  which 
occur  in  the  protein  compounds,  they  should  be  especially  concerned 
in  building  up  brain  and  nerves  and  keeping  them  in  repair.  The 
general  impression,  however,  is  that  people  whose  work  is  mental 
rather  than  physical  eat  too  much,  especially  fat  and  carbohydrates, 
and  that  the  ordinary  subsistence  diet  composed  of  100  grams  of 
protein,  56  grams  of  fat,  and  450  grams  of  carbohydrates  is  best 
suited  for  their  wants.  The  food  for  all  persons  of  leisure  should 
be  selected  with  a  view  of  preventing  overtaxing  the  digestive  tract, 
and  the  production  of  constipation  with  its  attending  evils,  such  as 
pelvic  congestion,  enlargement  of  the  liver,  hemorrhoids,  and  chronic 
dyspepsia.  The  legumes,  coarse  vegetables,  and  clarets  should  be 
avoided,  but  the  use  of  light  dry  wines,  fruits,  and  coffee  instead  of 
tea  may  be  encouraged. 

The  importance  of  a  good  set  of  teeth  for  complete  mastication 
and  avoidance  of  bolting  the  food,  in  order  to  secure  thorough  in- 
salivation,  has  already  been  pointed  out;  nor  should  we  underrate 
the  influence  of  our  frame  of  mind  upon  this  important  physiological 
function.  Every  meal  should  be  a  feast;  the  food  should  be  tempt- 
ingly served  and  monotony  avoided;  relishes  and  flavors  should  not 
be  wanting.  Pawlow,  in  1902,  has  shown  that  the  primary  secretion 
of  true  gastric  juice  is  the  result  of  a  reflex  starting  in  the  mouth 
and  that  the  relish  of  the  food  originates  the  reflex.  In  other  words, 
he  has  experimentally  demonstrated  why  certain  tempting  dishes, 
however  inexpensive,  "make  our  mouths  water,"  and  Hornborg,  in 
1904,  has  shown  that  distasteful  food  fails  to  cause  gastric  secretion. 

GOOD  FOOD  AT  REASONABLE  COST. 

[By  C.  F.  Lang  WORTHY,  Ph.  D.,  expert  in  nutrition.  Office  of  Experiment  Stations,  United 
States  Department  of  Agriculture.] 

The  human  body  needs  food,  air,  and  water  for  its  growth  and 
maintenance  just  as  do  all  living  things.  An  engine  can  not  run  a 
machine  or  draw  a  train  unless  it  has  fuel,  which  is  converted  into 
energy  or,  as  we  say,  which  is  used  to  generate  power.  In  the  same 
way  the  body  must  have  fuel  for  the  work  of  all  sorts  which  it  per- 
forms, for  instance,  for  the  work  expended  by  a  mason  in  laying 
stone,  or  by  a  carpenter  in  sawing  or  driving  nails,  by  a  woman  who 


140  BEPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

sweeps  or  does  her  housework,  or  by  a  child  who  runs  or  plays,  and 
the  body  must  also  have  fuel  for  the  work  which  goes  on  inside  it, 
such  as  the  beating  of  the  heart,  or  the  movement  of  the  chest  when 
we  breathe,  a  sort  of  work  which  is  less  often  thought  about  and  so 
less  familiar  to  most  of  us. 

Everyone  knows  that  a  large  engine  requires  more  fuel  than  a  small 
one,  and  that  if  the  work  is  severe  more  fuel  is  needed  than  is  the 
case  when  the  engine  is  simply  running  and  little  or  no  work  is  done. 
It  is  the  same  way  with  the  human  body.  A  large,  vigorous  man 
needs  more  food  than  a  small 'child  or  a  woman  who  is  not  more  than 
two-thirds  his  size,  and  if  a  man  or  woman  is  engaged  in  severe  work 
each  needs  more  food  than  when  idle,  the  need  being  manifested  by 
"  a  better  appetite."  Age  also  has  a  decided  effect  on  the  kind  and 
amount  of  food  needed,  an  aged  man  or  woman  naturally  requiring 
less  food  than  a  man  in  youth  or  middle  life,  since  the  daily  tasks 
and  the  amount  of  work  done  gradually  decrease  until  in  extreme  old 
age  most  of  the  time  is  passed  in  quiet.  Soft  foods  and  simple  dishes 
are  more  suited  to  old  age,  w^hen  teeth  are  few  and  body  vigor  is  much 
less  than  in  the  prime  of  life,  than  are  the  hearty  foods  which  strong 
men  and  women  need.  The  infant  needs  the  mother's  milk  and  later 
the  simple  foods — eggs,  milk,  bread,  vegetables,  cereals,  fruits,  etc., 
which  are  the  best  foods  for  childhood  and  are  most  certain  to  build 
up  a  vigorous  body.  As  childhood  passes,  the  mixed  diet  with  which 
most  of  us  are  familiar  is  commonly  followed  and,  all  things  con- 
sidered, is  doubtless  the  most  satisfactory  for  ordinary  persons  in 
health.  Such  a  diet  is  made  up  of  vegetables,  fruits,  flour  and  other 
products  from  cereal  grains,  meat,  fish,  dairy  products,  eggs,  and  so  on. 

Many  persons  have  an  idea  that  there  is  some  special  food,  some 
ideal  diet  suited  to  each  kind  of  work  and  to  every  condition  of  life, 
and  that  if  we  possessed  full  knowledge  of  the  subject  it  would  be 
desirable  to  prescribe  the  daily  fare  with  the  same  care  and  accuracy 
with  which  a  physician  prescribes  his  medicines,  but  this  does  not 
seem  to  be  the  case.  We  do  not  regulate  with  such  exactness  the  work 
we  do,  the  leisure  we  take,  the  amount  of  clothing  we  wear,  and  all 
other  conditions  of  our  daily  lives,  and  so  it  is  for  our  best  interest 
simply  to  regulate  our  diet  along  general  lines  in  accordance  with 
good  sense,  economy,  and  the  knowledge  which  has  been  gained  from  a 
scientific  study  of  the  subject,  taking  care  that  the  different  foods  are 
so  combined  that  all  the  needs  of  the  body  are  provided  for,  that 
excessive  waste  is  prevented,  and  that  both  undernourishment  and 
excess  or  overeating  are  avoided. 

It  is  essential  that  foods  should  be  of  good  quality,  clean,  and 
wholesome,  and  that  they  should  be  well  cooked.  The  dishes  that  are 
most  relished  and  the  methods  of  preparing  them  will  vary  in  different 
countries  and  in  different  regions  of  the  same  country,  for  each  race, 
and,  indeed,  each  region,  has  its  favorite  foods  and  its  special  methods 
of  cookery.  However,  when  the  question  of  food  is  carefully  studied, 
we  find  that  value  of  the  diet  expressed  in  scientific  terms  is  practi- 
cally the  same  the  world  over  when  we  consider  persons  of  like  size 
and  weight  performing  equal  aCmounts  of  work.  This  means  that 
just  as  an  engine  of  a  given  size  would  require  in  China  the  same 
amount  of  fuel  for  a  given  work  which  would.be  needed  in  the  United 
Stales,  so  the  human  machine  in  anj  part  of  the  world  requires  the 


REPORTS    OF    THE  PRESIDENT'S   HOMES   COMMISSION.  141 

same  amount  of  fuel,  that  is,  food,  for  a  given  task  which  would  be 
required  in  any  other  region. 

With  the  engine  it  is  immaterial  whether  the  fuel  be  wood,  coal,  or 
anything  else  which  is  convenient,  provided  the  quality  is  satisfactory 
and  the  engineer  knows  how  to  use  it.  With  the  human  machine  it  is 
something  the  same.  All  ordinary  foods  are  useful  when  rightly 
combined,  and  each  country  will  naturally  make  use  of  the  food 
supply  which  may  be  most  easily  and  economically  produced. 

A  study  of  the  various  materials  which  are  used  as  food  shows  that 
they  are  composed  of  comparatively  few  constituents,  namely,  water, 
mineral  matter,  starch,  sugar,  and  other  bodies  which  are  called  car- 
bohydrates, fat,  and  nitrogenous  material  commonly  called  protein, 
such  as  the  white  of  egg  and  the  lean  of  meat.  The  human  body  is 
made  up  of  the  same  constituents.  All  of  the  body  tissues  contain 
the  nitrogenous  material,  protein,  which  is  similar  to  that  found  in 
the  lean  of  meat,  the  white  of  egg,  in  gluten  of  wheat,  etc.,  and  so  it  is 
understandable  that  the  body  must  be  supplied  with  food  containing 
nitrogenous  material  enough  for  forming  this  tissue  and  for  replacing 
any  which,  like  the  skin,  finger  nails,  etc.,  may  be  worn  away  by  the 
various  conditions  of  our  daily  life  and  also  for  other  purposes  for 
which  the  body  requires  protein.  In  the  case  of  the  infant  the  nitrog- 
enous material  needed  for  body  growth  is  supplied  by  the  milk — a 
food  comparatively  rich  in  this  constituent  as  well  as  in  the  other 
nutrients.  Later  in  life  the  nitrogenous  material  is  supplied  largely 
by  milk,  cheese,  eggs,  meat,  cereals,  beans,  and  similar  foods. 

As  has  been  said,  men,  the  world  over,  of  like  size  and  performing 
like  amounts  of  work  apparently  eat  practically  the  same  amounts  of 
food  when  considered  from  the  standpoint  of  its  composition,  and 
students  of  nutrition  questions  are  very  generally  of  the  opinion  that 
this  fact  is  more  than  a  coincidence  and  that  these  average  quantities 
eaten  actually  represent  average  needs.  Values  deduced  from  such 
observations  are  commonly  referred  to  as  dietary  standards — that  is, 
guides  for  food  management. 

Expressed  in  its  simplest  terms,  the  dietary  standard  for  a  man  of 
medium  size,  say  150  pounds  in  weight,  in  good  health  and  perform- 
ing a  moderate  amount  of  work,  calls  for  100  grams  (or  3.5  ounces) 
of  nitrogenous  material  (protein),  and  fat  and  carbohydrates  enough 
to  supply  with  the  protein  3,500  calories  of  energy  in  the  amount  of 
food  provided  per  day.  There  is  always  some  waste  in  cooking  and 
serving  food,  and  if  we  consider  the  food  purchased  the  values  are 
115  grams  protein  (4  ounces)  and  3,800  calories.  These  terms  are  un- 
familiar to  most  persons,  and  it  is  unfortunate  that  some  terms  which 
are  more  familiar  can  not  be  found,  but  it  is  true  here  as  everywhere 
else  that  each  subject  requires  its  own  terms.  We  can  measure  cloth 
by  the  yard  or  milk  by  the  quart,  but  we  must  measure  work  by 
horsepower  or  electricity  by  terms  which  are  even  less  familiar.  For- 
tunately, in  the  case  of  food  and  diet  the  matter  can  be  explained  in 
other  ways  so  that  the  results  can  be  applied  in  home  management 
without  undue  difficulty. 

The  housekeeper  who  wishes  to  estimate  the  nutritive  value  of  the 
food  she  prepares,  in  order  that  she  may  conform  with  the  suggested 
dietary  standards,  can  readily  do  so  by  the  use  of  such  a  table  as  the 
one  here  given,  which  shows  the  protein  and  energy  value  of  the  por- 


142 


REPOBTS   OF   THE  PRESIDENT  S   HOMES  COMMISSION. 


tions  ordinarily  served  of  the  more  common  food  materials,  the 
values  given  being  approximately  only,  as  it  would  be  hardly  desir- 
able to  state  absolute  figures  for  such  a  purpose  as  that  for  which  the 
table  is  designed. 

The  weights  of  the  food  portions  included  in  the  table  are  given  in 
both  grams,  the  unit  of  weight  commonly  used  in  scientific  work,  and 
in  ounces,  the  more  common  household  unit.  To  avoid  unusual  frac- 
tions of  an  ounce  the  nearest  half  ounce  or  quarter  ounce  or  some 
similar  common  fraction  is  used  instead  of  more  accurate  equivalents. 

In  such  a  table  the  protein  content  of  the  food  gives  an  idea  of  its 
relative  value  for  building  body  tissue.  The  value  of  the  food  as  a 
source  of  power  for  carrying  on  work  is  expressed  by  the  energy  it 
supplies  when  utilized  in  the  body  as  fuel  is  burned  under  a  boiler, 
and  is  measured  as  calories.  A  calorie  is  equal  very  nearly  to  1.54 
foot-tons — that  is,  it  represents  force  which  would  be  sufficient  to  lift 
1  ton  1.54  feet — and  is  a  more  convenient  unit  for  such  purposes 
than  horsepower  or  other  similar  unit. 

Approximate  weight  and  nutritive  value  of  an  average  portion  of  some  common 

foods. 


Kind  of  food. 


1  slice  of  roast  meat 

1  portion  of  meat  stew 

1  Frankfurt  sausage 

1  pork  chop 

1  slice  of  boiled  bacon 

1  portion  of  fried  bacon 

1  portion  of  steak 

1  portion  of  meat  soup 

1  portion  of  pea  or  bean  soup 

1  cup  or  glass  of  milk 

1  cup  or  glass  of  skim  milk  or  buttermilk 

1  portion  of  cream .* 

legg 

1  portion  of  butter 

1  portion  of  cheese 

1  baked  or  boiled  potato 

1  portion  of  turnip,  beet.carrot,  or  similar 

vegetable. 
1  ear  of  green  corn  or  1  portion  of  stewed 

corn. 
1  tomato  or  1  portion  of  stewed  tomato. . 
1  serving  of  cooked  spinach,  cabbage,  or 

other  green  vegetable. 
1  portion  of  baked  beans  or  black-eyed 

peas. 

1  slice  of  bread 

1  portion  of  com  bread 

1  slice  of  cake 

1  slice  of  apple  or  other  fruit  pie 

1  cup  of  flour 

1  teaspoonful  of  sugar 

1  cup  of  sugar 

1  portion  of  sirup  or  molasses 

1  portion  of  cooked  cereal 

1  portion  of  dry  ready  to  eat  cereal 

M  i  Ik  f  or  cereal 

1  portion  of  boiled  rice 

1  portion  of  rice  pudding,  bread  pudding, 

or  similar  cuitard  pudding. 
1  portion  of  cherry  roll  or  similar  pudding 

1  apple  or  pear 

1  banana 

1  orange 

1  peach  or  2  plums 

1  portion  of  stewed  prunes 

1  portion  of  preserves 

1  portion  of  fresh  berries 


Average  weight 
of  portion. 


Grams.   Ounces 


325 

60 

190 

100 

50 

100 

190 

190 

225 

225 

65 

50 

10 

20 

140 

130 

75 

95 
126 

200 

60 

50 

60 

150 

225 

10 

226 

76 

200 

50 

25 

140 

176 

176 
100 
100 
126 

75 
100 

65 
100 


3 
11 
2 
7 
3i 
2 
3J 
7 
7 
8 
8 
2 
2 

4J 


Average  bulk  of  por- 
tion. 


Saucerful . 


Cupful 

do 

One-half  pint. 
do 

One-half  gill.. 


Protein, 
grams. 


1-inch  cube. 


Medium  size,  3  inches 

long. 
Saucerful 


.do 


.do. 
.do. 


.do. 


4  by  4  by  1  Inches. 

3  by  3  by  1  inches. 

4  by  2  by  1  inches. 
One-sixth  of  a  pie. 
One-half  pint 


One-half  pint 

About  one-half  gill. 

Saucerful 

do 

One-half  gill 

Saucerful 

do 


Slice. 


Saucerful . 

do.... 

do.... 


Energy, 
calories. 


197 
461 
170 
765 
432 
252 
411 
60 
70 
170 
86 
130 
96 
95 
94 
145 


25 
40 

300 

175 
142 
190 
440 
960 

40 
890 
200 
170 
200 

40 
155 


50 
70 
50 
36 
116 
160 
35 


EEPORTS   OF   THE  PRESIDENT  S   HOMES   COMMISSION. 


143 


The  table  may  be  conveniently  used  by  supposing  that  the  food 
eaten  by  one  member  of  the  family  will  represent  in  character  and 
amount  the  food  for  the  entire  family.  To  estimate  by  means  of 
the  table  the  food  value  of  the  diet,  the  portions  of  each  article  used 
at  each  meal  should  be  set  down  in  order,  together  Avith  the  protein 
and  energy  which  each  supplies,  and  the  total  sum  of  the  protein  and 
of  the  energy  will  represent  the  amount  eaten  in  the  whole  day. 

Suppose,  for  instance,  that  breakfast  for  the  man  of  the  family,  a 
mechanic,  whose  work  calls  for  a  medium  expenditure  of  physical 
strength,  consists  of  2  slices  of  bread,  1  portion  of  butter,  a  potato, 
2  cups  of  coffee,  and  2  eggs.  Each  slice  of  bread,  as  the  table  shows, 
supplies  4  grams  protein  and  175  calories.  Two  slices  would  there- 
fore supply  8  grams  protein  and  350  calories.  A  portion  of  butter 
supplies  95  calories  of  energy.  Butter,  as  will  be  noted,  contains  no 
protein.  One  potato  would  supply  4  grams  of  protein  and  145 
calories;  2  eggs  14  grams  protein  and  192  calories.  Tea  and  coffee 
in  themselves  supply  so  little  nutritive  material  that  they  may  be 
neglected.  The  sugar  and  cream,  however,  which  would  be  used 
should  be  taken  into  account.  If  in  each  cup  of  coffee  a  teaspoonful 
of  sugar  is  used,  the  amount  for  two  cups  would  of  course  be  two 
teaspoonfuls,  and  the  energy  value  80  calories.  As  the  table  shows, 
sugar  contains  no  protein.  When  one-quarter  gill  of  cream  is  used 
for  each  cup  of  coffee  one-half  gill  will  be  used  for  two  cups,  and 
according  to  the  figures  in  the  table  would  supply  2  grams  protein 
and  130  calories.  If  these  foods  eaten  at  breakfast  and  the  protein 
and  energy  which  they  supply  are  set  down  in  order  and  the  quan- 
tities added  together,  the  total  shows  the  amount  eaten  for  breakfast, 
as  follows: 

Food  value  of  hreakfast. 


Protein. 


Energy. 


2  slices  bread 

1  portion  butter 

1  potato 

2eggs 

2  cups  coffee 

2  teaspoonfuls  sugar  for  coffee 
One-half  gill  cream  for  coffee. 

Total 


Grams. 

Calories. 

8 

350 

0 

95 

4 

145 

14 

192 

0 

0 

0 

80 

2 

130 

28 


992 


In  the  day's  ration  which  has  been  selected  we  will  suppose  that  the 
man  carries  his  lunch  and  that  it  consists  of  two  sandwiches  (made 
from  four  slices  of  bread,  one  portion  of  butter,  and  two  portions  of 
cheese)  a  slice  of  cake,  and  a  banana,  and  that  for  dinner  he  has  one 
portion  of  beefsteak,  one  potato,  one  serving  of  turnips,  an  ear  of 
corn,  one  slice  of  bread,  one  portion  of  butter,  a  dish  of  rice  pudding, 
and  one  cup  of  tea  withl sugar  and  milk.  Following  the  same  method 
as  was  used  in  computing  the  value  of  breakfast,  the  lunch  would 
supply  the  following. 


144  REPORTS   OF   THE   PRESIDENT'S   HOMES   COMMISSION. 

Food  value  of  lunch. 


Protein. 


Energy. 


4  slices  of  bread  for  sandwiches. . 
2  portions  cheese  for  sandwiches 
1  portion  butter  for  sandwiches. . 

1  slice  cake 

1  banana 

Total 


Grams. 

Calories. 

16 

700 

10 

198 

0 

95 

8 

19C 

0 

70 

29 


1,253 


The  protein  and  energy  value  of  dinner  computed  in  the  same  way 
would  be  as  follows: 

Food  value  of  dinner. 


Protein. 


Energy. 


1  portion  beefsteak 

1  potato 

1  portion  turnips 

1  ear  corn 

1  slice  bread 

1  portion  butter 

1  dish  rice  pudding 

1  cup  tea 

1  teaspoonful  sugar  for  1  cup  tea. . 
One-quarter  gill  milk  for  1  cup  tea 

Total 


Grams. 

Calories. 

26 

411 

4 

145 

1 

80 

2 

82 

4 

176 

0 

95 

7 

300 

0 

0 

0 

40 

1 

20 

45 


1,348 


The  total  protein  and  energy  of  the  food  eaten  by  the  man  during 
the  day  would  of  course  be  the  sums  of  the  amounts  for  breakfast, 
lunch,  and  dinner,  as  follows: 

Food  value  of  day's  ration. 


Protein. 

Energy. 

Breakfast 

Orams. 

28 
29 
45 

Calories. 
992 

Lunch ....             ....                 

1,253 
1,348 

Dinner 

Total .            

102 

3  593 

As  will  be  seen  from  the  figures  given  above,  the  total  protein  for 
the  day's  ration  is  102  grams,  or  3f  ounces,  and  the  total  energy  value 
3,593  calories — values  which  correspond  very  closely  with  those  called 
for  by  the  suggested  dietary  standard.  If  a  little  more  or  a  little  less 
food  were  eaten  these  figures  would  vary  somewhat,  though  the  agree- 
ment might  still  be  reasonably  close.  Suppose,  for  instance,  that 
another  portion  of  cheese  had  been  used  in  making  the  sandwiches. 
This  would  have  added  5  grams  of  protein  and  94  calories,  making 
the  total  amount  107  grams  protein  and  3,687  calories.  Such  varia- 
tions are,  of  course,  what  might  be  expected  and  are  of  no  particular 
moment.  It  is  by  no  means  necessary  that  the  food  eacli  (\\\y  should 
agree  exactly  with  the  suggested  dietary  standard,  for  any  deficiency 
in  protein  or  energy  one  day  will  very  probably  be  offset  by  an  excess 


REPORTS   OF   THE  PRESIDENT'S   HOMES   COMMISSION.  145 

on  some  other  day.  It  is  believed,  however,  that  the  daily  food  will 
be  most  satisfactory  when  the  average  for  long  periods  agrees  with 
the  suggested  values.  The  calculated  values  obtained  by  the  methods 
outlined  above  are  designed  simply  to  show  in  a  general  way  whether 
the  food  corresponds  to  the  dietary  standard  and  to  afford  the  house- 
wife some  knowledge  as  to  whether  the  meals  which  she  provides  are 
sufficient  as  to  the  kind  and  amount  of  nutritive  material  which  they 
furnish. 

In  the  table  on  page  142  only  the  more  common  foods  and  staple 
dishes  have  been  included.  It  will  very  often  happen  that  other 
foods  and  dishes  will  be  served.  When  this  is  done,  and  it  is  desired 
to  calculate  the  relative  value  of  the  ration,  no  great  error  will  ordi- 
narily be  involved  if  the  values  of  the  food  most  like  the  article  in 
question  are  used.  For  instance,  griddlecakes  or  waffles,  which  are 
often  served  at  breakfast,  are  not  given  in  the  table.  A  griddlecake 
or  a  waffle  so  closely  resembles  a  slice  of  bread  in  food  value  that  the 
protein  and  energy  for  a  slice  of  bread  may  be  used  to  represent  the 
food  value  of  each  griddlecake  or  waffle  served.  In  the  same  way  an 
ordinary  portion  of  boiled  lamb  may  be  assumed  to  have  the  same 
food  value  as  a  slice  of  roast  beef,  and  a  portion  of  pork  sausage  the 
same  food  value  as  a  Frankfurt  sausage.  If  a  housekeeper  desires  to 
study  the  subject  in  greater  detail  she  will  find  an  abundance  of  data 
regarding  the  composition  of  foods,  etc.,  in  bulletins  of  the  United 
States  Department  of  Agriculture  and  elsewhere. 

In  the  calculations  which  have  been  described  nothing  has  been  said 
of  the  fact  that  women  and  children  usually  eat  smaller  amounts  than 
men.  Taking  such  factors  into  account  would  complicate  the  calcu- 
lations, and  it  is  therefore  easiest  to  take  into  account  simply  the 
amounts  which  the  man  of  the  family  eats,  and  to  assume  that,  as  the 
same  sort  of  food  is  provided  for  the  family,  each  member  will  re- 
ceive the  proper  amount,  and  that  if  a  diet  for  the  man  corresponds 
reasonably  to  the  dietary  standard  the  same  may  be  supposed  to  be 
the  case  with  that  for  the  other  members  of  the  family.  Young 
children,  of  course,  would  have  milk  or  special  foods,  and  so  would  be 
considered  separately. 

The  ways  in  which  meat,  fish,  vegetables,  and  other  common  foods 
can  be  prepared  for  the  table  are  endless,  ranging  all  the  way  from 
the  simple  boiled  potato  or  fried  egg  to  the  most  elaborate  dish  of  the 
highly  trained  cook.  The  ideal  for  family  living  is  enough  variety  in 
food  and  method  of  preparation  to  make  the  daily  fare  attractive 
without  excessive  cost  or  undue  labor,  and  it  is  possible  to  attain  this 
ideal.  It  is  just  as  possible  to  make  a  dinner  pleasing  and  satisfactory 
in  every  way  from  simple  materials  simply  cooked  as  it  is  to  make  ap- 
propriate and  attractive  clothing  for  a  child  or  grown  person  from  in- 
expensive yet  suitable  and  well-chosen  materials.  It  is  the  way  in 
which  it  is  done  as  much  as  the  materials  used.  Anyone  who  works 
in  a  mill  or  factory  with  a  complicated  machine  knows  that  many 
things  must  be  learned  before  the  machine  can  be  intelligently  man- 
aged and  that  much  practice  is  required  before  he  can  become  a  skilled 
operator.  The  same  is  true  of  selection  and  preparation  of  food  and 
other  household  tasks,  but  it  is  equally  true  that  the  skill  and  ability 
which  comes  from  good  training  is  just  as  valuable  in  the  home  as  it 
is  in  the  factory  or  workshop,  and  that  the  well-trained  worker  can 
S.  Doc.  644,  60-2 11 


146  REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSCON. 

accomplish  better  results  with  less  trouble  in  a  given  time  than  the 
unskilled  or  poorly  trained  worker. 

If  we  look  over  the  long  list  of  foods  which  we  use  and  the  dishes 
we  make  from  them,  it  becomes  evident  that  they  are  of  two  general 
sorts — those  which,  like  bread,  rice,  potatoes,  and  many  other  foods, 
have  little  distinctive  taste,  and  those  like  cabbage,  onions,  cheese, 
sweet  foods,  and  many  other  dishes,  which  possess  a  pronounced  and 
characteristic  flavor.  It  also  becomes  evident,  when  the  subject  is 
studied,  that  the  foods  which  are  used  in  greatest  quantity  belong  to 
the. former  class. 

A  little  butter  and  jam  make  a  slice  of  bread  something  which  a 
child  will  eat  with  relish.  It  is  equally  true  that  it  is  the  foods  and 
dishes  of  distinctive  flavor  which  very  largely  at  least  make  the  daily 
fare  appetizing  and  satisfactory  and  which  insure  the  consumption  of 
enough  of  the  staple  foods,  many  of  them  lacking  in  flavor,  to  make 
the  diet  well  balanced  and  adequate.  This  distinctive  flavor  or  pala- 
tability  which  is  so  desirable  may,  in  general,  be  attained  in  two 
ways — namely,  by  the  use  of  foods  which  are  in  themselves  of  dis- 
tinctive flavor,  and  by  appetizing  methods  of  cookery  with  proper 
seasoning. 

The  art  of  housekeeping  in  its  highest  form  consists  in  planning  the 
meals  so  that  the  two  classes  of  foods  are  well  balanced  and  the  cost 
kept  within  bounds,  as  related  to  the  income,  with  the  labor  involved 
not  excessive. 

Many  housekeepers,  since  they  have  been  well  trained  in  youth  by 
their  mothers  or  in  other  ways  have  learned  how  to  be  good  home- 
makers,  instinctively  provide  tasty  dishes  in  about  the  right  propor- 
tion to  the  bread,  potatoes,  and  other  staple  foods,  and  those  who  do 
not  know  how  to  do  so  should  make  the  effort  to  learn.  Such  prob- 
lems can  often  be  solved  by  care  and  attention,  and  by  means  of 
schools  and  classes  for  home  economics  and  the  like  ways  of  good 
housekeeping  are  readily  taught.  For  instance,  if  we  assume  that 
bread  of  some  sort  and  coffee  and  some  of  the  ordinary  cereals  are  the 
usual  breakfast  dishes,  and  they  doubtless  are  with  the  majority  of 
families  in  this  country,  the  needed  variety  is  readily  secured  by  bacon 
or  creamed  fish,  fish  balls,  eggs,  honey,  sirup,  or  other  foods.  If  work 
is  light  and  a  hearty  breakfast  is  not  needed,  fried  potatoes  (perhaps 
seasoned  with  onions) ,  fried  apples,  or  some  similar  dish  is  a  palatable 
addition  to  creamed  toast,  cereal,  or  the  bread  and  butter  which 
makes  up  the  principal  part  of  the  meal  if  that  is  not  thought  to  be 
enough. 

Tea  and  coffee  as  a  part  of  breakfast  or  other  meal  owe  their  food 
value  mainly  to  the  sugar  and  milk  or  cream  commonly  taken  with 
them.  Cocoa  in  itself  contains  rather  more  nutritive  material  than 
either  tea  or  coffee,  but  also  owes  its  food  value  for  breakfast  or  any 
other  meal  largely  to  the  milk  and  sugar  which  are  used  in  making  it. 
It  is  usually  considered  more  satisfactory  for  children  than  either  tea 
or  coffee.  The  value  of  milk  as  a  beverage,  particularly  for  children, 
must  never  be  overlooked.  Skim  milk  is  not  usually  fully  appreciated 
for  this  purpose.  It  is,  of  course,  "  thinner  "  or  "  less  hearty  "  than 
whole  milk,  as  it  has  less  fat  (cream) — but  is  still  a  nutritious  food — 
and  though  rather  dilute,  like  all  liquid  foods,  is  well  worth  using  in 
quantity. 


BEPORTS  OF   THE  PEESIDENt's  HOMES  COMMISSION.  147 

When  the  man  of  a  family  takes  his  lunch  away  to  his  work  some- 
thing should  be  provided  which  is  palatable  as  well  as  capable  of 
satisfying  hunger.  Cold  meat,  a  little  smoked  fish,  or  a  chopped 
boiled  egg  will  make  a  sandwich  which  is  more  palatable  and  more 
nutritious  than  plain  bread  and  butter,  and  cheese  of  different  kinds, 
cold  bacon,  and  many  other  things  may  be  used  in  the  same  way,  while 
an  apple,  a  banana,  or  a  piece  of  cake  or  something  similar  will  un- 
doubtedly be  relished  as  much  as  the  hearty  food.  If  the  children 
come  home  from  school  they  and  their  mother  should  have  something 
which  is  suited  to  their  needs  and  yet  which  does  not  involve  too  much 
trouble.  Bread  and  milk,  or  cereal  and  milk,  with  fruit,  fresh  or 
cooked,  are  all  simple  and  easily  prepared  dishes  which  are  suitable 
for  the  purpose,  while  bread  and  butter  with  a  little  cold  meat,  fruit, 
tomatoes,  or  any  left-over  foods  which  are  relished  will  also  answer 
the  purpose. 

The  evening  meal  under  such  circumstances  would  naturally  be  the 
heaviest  meal  of  the  day.  If  dinner  is  eaten  in  the  middle  of  the  day 
and  supper  at  night,  the  suggestions  made  for  lunch  may  be  applied 
to  supper,  but  some  hot  dish  is  an  addition  which  most  persons  relish 
for  supper.  Creamed  chipped  beef,  hash,  meat  croquettes,  oysters  in 
season,  and  similar  dishes  suggest  themselves,  but  if  so  hearty  foods 
are  not  wanted  creamed  potatoes,  corn  chowder,  fried  tomatoes,  and 
others  may  be  readily  prepared. 

When  roast  beef,  which  is  usually  an  expensive  dish,  is  the  princi- 
pal item  of  a  dinner,  the  cost  of  the  meal  may  be  kept  within  reason- 
able limits  by  serving  inexpensive  vegetables  and  dessert.  Any  meat 
left  over  from  the  roast  should  be  used  for  some  other  meal,  either 
cold  or  made  into  a  meat  pie,  meat  croquettes,  hash,  or  some  other 
made  dish,  while  any  bones  and  scraps  made  into  a  well-seasoned 
thick  soup  may  form  the  principal  dish  at  still  another  meal. 

Hamburg  steak,  round  steak,  ham,  and  sausages  are  meats  which 
may  be  readily  cooked  and  which  are  appetizing,  while  pork  chops 
have  always  been  a  favorite  and  are  usually  considerably  less  expen- 
sive than  similar  cuts  of  beef  or  lamb. 

Herring,  mackerel,  and  other  sorts  of  fish,  when  in  season,  make  a 
pleasant  variety  and  are  as  nutritious  as  meat.  Perhaps  fish  is  most 
commonly  fried,  but  boiled  fish  with  a  well-made  sauce,  or  fish  stuffed 
and  baked,  is  as  easily  prepared  and  adds  variety. 

Custom  has  made  it  almost  compulsory  in  this  country  to  have 
some  sweet  dish  at  dinner,  and  the  custom  is  reasonable,  as  such  foods 
are  palatable,  and  although  badly  made  pastry  and  other  desserts  are 
frequent  causes  of  digestive  disturbances  such  dishes  when  well  made 
and  eaten  at  suitable  times  in  reasonable  quantity  are  generally  con- 
ceded to  be  wholesome  and  are  reasonably  nutritious. 

A  housekeeper  who  plans  her  meals  rationally  will  serve  a  light 
dessert  like  stewed  fruit  with  or  without  simple  cakes  or  cookies,  a 
simple  rice  pudding,  or  some  similar  dish  with  a  hearty  meat,  and  the 
heavy  puddings,  such  as  apple  dumplings,  suet  pudding,  etc.,  when 
the  rest  of  the  dinner  is  not  so  hearty. 

Beets,  cabbage,  onions,  carrots,  spinach,  green  com,  tomatoes — in- 
deed, all  the  ordinary  vegetables — are  wholesome,  valuable  fcDds  and 
should  be  used  liberally.  They  contain  a  good  deal  of  water  and  are 
bulky  in  proportion  to  their  nutritive  value,  but  this  is  in  their  favor. 


148 

By  care  and  thought  in  selecting  and  by  different  methods  of  cooking 
vegetables  and  other  foods  it  is  easy  to  vary  the  dinner  from  day  to 
day  without  too  much  labor. 

When  most  fresh  vegetables  are  out  of  season  or  high  in  price, 
hominy,  rice,  fried  corn-meal  mush,  and  similar  dishes  are  pleasant 
changes  from  canned  corn,  canned  tomatoes,  and  other  canned  goods 
which  are  so  much  used  to  supplement  potatoes,  the  standard  vegeta- 
ble in  most  American  homes,  and  which,  when  of  good  quality,  are 
useful  foods. 

Fresh  fruits  are  always  attractive  additions  to  the  diet  and  may  be 
made  to  furnish  a  considerable  amount  of  nutritive  material.  Canned 
fruits,  jams,  jellies,  and  the  like  are  all  valuable  additions  to  the  diet, 
useful  for  their  nutritive  value  and  for  their  palatable  flavor. 

In  earlier  times  in  New  England  creamed  salt  codfish  with  baked 
potatoes,  boiled  salt  salmon  with  drawn  butter,  boiled  salt  codfish 
with  beets  and  boiled  potatoes,  and  pork  and  beans  were  simple, 
inexpensive,  and  appetizing  dinner  dishes  which  were  very  commonly 
used.  These  foods  are  wholesome,  nourishing,  and  have  always  been 
favorites  in  large  numbers  of  families.  Fried  salt  pork  or  bacon, 
well  cooked,  with  cream  gravy,  and  served  with  fried  eggs  and  baked 
potatoes,  is  another  old-fashioned  dinner  which  retains  its  popular- 
ity, particularly  in  rural  regions.  Some  such  dish  as  this  with  hot 
corn  bread,  some  vegetable  which  is  in  season,  and  a  rice  pudding  or 
some  other  simple  dessert  makes  a  meal  which  is  appetizing,  ade- 
quate, easily  prepared,  and  not  expensive. 

In  the  Southern  States  hominy  and  rice,  like  corn  breads  of  differ- 
ent sorts,  have  always  been  favorite  dishes  of  reasonable  cost.  Corn 
bread  and  buttermilk  is  an  old-fashioned  combination  which  is  well 
worth  more  extended  use,  for  it  is  nutritious,  wholesome,  and  to  most 
people  palatable. 

The  dishes  and  food  combinations  which  have  been  mentioned  are 
only  suggestions,  for  each  housewife  must  of  necessity  suit  her  meals 
to  the  tastes  of  her  family,  and  food  customs  differ  decidedly  with 
regions  and  with  other  circumstances.  The  southerner  will  relish 
bacon  and  greens,  fried  chicken,  com  bread,  and  many  other  dishes 
for  which  southern  cooks  are  famous,  while  the  northerner  will  per- 
haps prefer  fish-balls,  baked  beans  and  brown  bread,  or  "  a  boiled 
dinner "  of  corn  beef  with  vegetables,  or  some  similar  dish  with 
which  he  has  always  been  familiar.  Families  of  Italian  origin  or. 
descent  naturally  use  macaroni,  which  they  cook  in  such  appetizing 
ways  with  tomatoes,  cheese,  or  other  seasoning,  salads  with  an  abun- 
dance of  olive  oil,  and  other  dishes  whi  ;h  are  typical  of  Italy,  while 
the  Germans  will  more  commonly  select  noodle  soup,  pork  cutlet 
with  cabbage  or  sauerkraut,  apple  cake,  and  many  of  the  other  char- 
acteristic and  appetizing  German  dishes. 

Readiness  to  adopt  new  ideas  is  characteristic  of  American  life 
and,  as  might  be  expected,  many  of  the  typical  dishes  of  other  coun- 
tries have  become  well  known  on  most  tables,  and  this  may  well  be 
the  case  for,  after  all,  the  staple  foods  which  are  always  in  market 
and  reasonable  in  price  are  not  too  numerous  and  new  methods  of 
cooking  mean  a  pleasant  variety. 

In  general,  it  is  true  that  to  be  reasonable  in  cost  usually  means 
that  more  time  is  required  for  the  preparation  of  a  monl  or  a  dish 
than  is  the  case  when  cost  is  not  taken  into  account.     A  steak  or  chop 


REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  149 

which  can  be  quickly  cooked  is  more  costly  than  a  stew,  than  beef 
or  veal  loaf,  beef  a  la  mode,  pot  roast,  beef  with  horse  radish,  boiled 
mutton  with  white  sauce,  or  any  of  the  other  appetizing  dishes 
which  can  be  made  from  the  cheaper  cuts  of  meat.  The  stew  owes 
its  palatabiltiy  very  largely  to  the  onions  or  other  seasoning,  or  to 
the  fact  that  the  meat  was  browned  in  a  pan  before  it  was  stewed, 
and  its  pleasing  texture  to  the  long,  slow  cooking  which  makes  tough 
meat  tender.  The  steak  or  chop  is  in  itself  more  tender  and  full 
of  flavor  than  cheaper  cuts,  so  it  is  reasonable  that  a  simpler  method 
of  cooking  is  required  for  it.  That  such  dishes  as  stews,  etc.,  are 
very  generally  relished  by  people  in  all  circumstances  is  shown  by 
the  fact  that  they  so  often  appear  on  menus  in  expensive  hotels  and 
restaurants,  as  well  as  those  where  prices  are  cheaper,  though  more 
often  as  luncheon  than  dinner  dishes,  and  find  their  way  to  most 
tables — no  matter  how  large  or  how  small  the  income. 

Granting  that  the  foods  are  w^holesome  and  suitable,  the  final  test 
with  foods,  after  all,  is  skill  in  preparation.  The  simplest  dish 
well  cooked  is  always  superior  to  an  elaborate  dish  indifferently 
made  and  simple  meals  in  the  long  run  are  more  relished  than  those 
which  are  very  elaborate. 

The  housekeeper  who  manages  her  home  with  little  or  no  help 
except  that  which  other  members  of  her  family  give  has  no  time  to 
waste  on  the  entrees,  elaborate  cakes,  and  other  sorts  of  "  food  fancy 
work "  for  which  recipes  are  so  frequently  published  and  which 
many  people  seem  to  consider  a  mark  of  good  living.  It  should  be 
said  that  well-informed  housekeepers  long  ago  recognized  that  the 
majority  of  such  dishes  can  not  be  satisfactorily  prepared  except  by 
an  unusually  skillful  cook  and  that,  though  entirely  appropriate  for 
special  occasions  and  under  many  circumstances,  they  have  little 
place  in  the  everyday  bill  of  fare.  Furthermore,  most  persons  tire 
of  such  dishes  much  more  quickly  than  they  do  of  foods  prepared  by 
simpler  methods. 

As  time  has  progressed  very  many  household  industries  have 
become  the  subject  of  careful  study  with  the  result  that  they  now  rest 
on  a  sound  scientific  basis. 

The  perfection  which  has  been  reached  in  spinning  and  weaving 
and  other  manufacturing  enterprises,  which  have  grown  out  of 
home  industries,  is  a  proof  of  what  may  be  accomplished  by  a  scien- 
tific study  of  domestic  problems  and  an  indication  of  what  may  be 
expected  when  careful  consideration  is  given  to  food  and  nutrition 
as  a  part  of  home  work  by  all  housekeepers. 

In  the  development  of  labor-saving  devices  household  work  has  not 
kept  pace  with  farm  work  or  with  general  manufacturing.  How- 
ever, at  the  present  time  new  interest  seems  to  have  been  aroused  in 
this  question,  and  dishwashers,  bread  and  cake  mixers,  and  similar 
devices  which  are  on  the  market,  and  hay  boxes  or  fireless  cookers 
are  becoming  fairly  well  known.  When  such  devices  are  found  to 
be  fairly  satisfactory  they  should  find  a  place  in  the  home  with  the 
washing  machine  and  the  carpet  sweeper  as  a  means  of  lessening  the 
labors  of  the  housekeeper. 

No  carpenter  can  build  a  house  or  carry  out  even  a  simple  enter- 
prise without  a  plan,  and  the  better  the  plan  the  easier  and  more 
satisfactory  will  be  the 'work,  other  things  being  equal.  With  the 
housbkeeper  the  same  is  true.     Thought  and  system  are  important 


150  REPOBTS  OF  THE  PRESIDENT'S  HOMES  COMMISSION. 

time  and  strength  savers.  We  do  not  need  to  live  by  rote,  but  simply 
to  carry  on  the  household  tasks  according  to  some  definite  plan  which 
is  flexible  enough  to  permit  of  the  variations  made  necessary  by  cir- 
cumstances. 

The  housekeeper  who  will  take  advantage  of  opportunities  to  learn 
something  regarding  the  relative  nutritive  value  of  different  foods 
and  their  real  worth  as  distinguished  from  their  market  value,  and 
who  understands  good,  sensible  methods  of  cooking  and  serving  food, 
and  who  will  plan  her  meals  and  other  household  work  so  that  un- 
necessary labor  may  be  avoided,  will  be  able  to  provide  her  family 
with  a  reasonable  and  palatable  diet  without  undue  labor  or  excessive 
cost.  Thanks  to  its  varied  climate  and  soil,  the  United  States  pro- 
duces all  staple  foods  in  great  variety,  as  well  as  the  majority  of  those 
which  are  usually  termed  "  luxuries,"  and  for  this  and  other  reasons 
tlie  food  problem  is  a  simpler  one  than  is  the  case  in  many  other 
countries  where  food  materials  are  less  plentifully  grown  and  prices 
are  higher.  Good,  substantial  food,  pleasing  to  the  eye  as  well  as 
satisfying  the  body,  is  within  the  reach  of  all,  and  w^ien  wholesome, 
well-prepared  meals  are  the  rule  in  our  homes  and  women's  work  in 
the  household  is  carried  on  generally  with  the  system  and  precision 
which  were  long  ago  introduced  into  the  trades  and  manufacturing 
industries,  then  household  work  will  be  less  a  burden  and  the  family 
will  be  healthier  and  better  in  every  way. 

FOOD   AND    HOME   BETTERMENT. 

[Introduction  by  Geo.  M.  Kober,  M.  D.] 

In  our  sociological  study  of  families  in  this  city  we  found  that  476 
families,  with  an  income  of  $500  or  less,  expended  43.68  per  cent  of 
their  annual  income  for  food;  159  families,  with  an  income  of  $500 
to  $600,  43.59  per  cent ;  153  families,  with  an  income  of  $600  to  $700, 
41.40  per  cent;  and  153  families,  with  an  income  of  $700  to  $800, 
40.21  per  cent  for  food.  The  question  of  food,  while  of  importance 
to  all  classes  in  its  relation  to  health  and  efficiency,  is  of  special 
significance  from  an  economic  standpoint  in  families  with  limited 
means.  It  has  been  well  said  that  "  half  the  struggle  for  life  is  the 
struggle  for  food."  Many  of  the  problems  tonnected  with  the  nutri- 
tive value  of  farm  products  and  other  foods,  the  preparation  of  food 
for  the  table,  the  digestibility,  palatability,  and  utilization  of  differ- 
ent foodstuffs,  the  hygienic  and  economic  aspect  of  the  question  have 
received  careful  attention  in  the  nutrition  investigations  conducted  by 
the  Office  of  Experiment  Stations,  United  States  Department  of 
Agriculture.  It  may  be  truly  said  that  these  investigations  have  been 
a  constant  source  of  information  and  inspiration  to  teachers  of 
domestic  science  in  public  schools  and  colleges,  to  settlement  workers, 
persons  in  charge  of  charitable  institutions,  and  others  interested  in 
the  social  betterment  of  their  less  resourceful  neighbors.  The  work 
is  of  the  utmost  value,  and,  while  much  has  been  accomplished,  it 
should  be  continued  in  the  interest  of  home  economics  and  home 
betterment. 

It  has  been  found,  over  and  over  again,  that  persons  of  limited 
means  purchase  food  containing  little  or  no  nutriment,  or  select 
needlessly  expensive  kinds  of  food,  or  prepare  a  diet  altogether  too 
one-sided,  and  last,  but  not  least,  know  little  or  nothing  about  the  art 
of  cooking,  and  thus  impair  not  only  the  nutritive  value  of  the  food. 


REPOKTS    OF    THE  PRESIDENT  S   HOMES   COMMISSIOTST. 


151 


but  also  the  digestive  functions  and  general  health  as  well.  In  order 
to  give  housekeepers  whose  income  is  $1.50  a  day  an  opportunity  to 
prepare  suitable  dishes  for  a  family  of  6 — 2  adults  and  4  children — 
Miss  E.  M.  Cross,  of  the  McKinley  Manual  Training  School,  has 
prepared  suitable  menus  for  winter  and  summer  use  which  it  is 
hoped  will  stimulate  interest  in  the  subject.  Miss  Cross  assures  me 
that  she  has  verified  the  market  prices  personally  and  that  the  food 
can  be  purchased  at  the  figures  given.  For  reasons  already  stated 
butterine  may  very  properly  replace  butter  in  families  with  small 
means,  and  for  hygienic  reasons  bread  twenty-four  hours  old  is 
really  superior  to  fresh  bread.  The  writer  desires  to  emphasize  the 
fact  that  beans,  peas,  and  lintels,  containing,  as  they  do,  much  protein, 
can  replace  from  time  to  time  the  more  expensive  meat  and  egg  ration. 
The  nutritive  value  of  skim  milk,  buttermilk,  and  cottage  cheese, 
and  the  cheaper  fish  meats  should  also  be  more  fully  appreciated. 
To  limit  the  expenditure  for  food,  with  an  income  of  $1.50  to  an 
average  of  75  cents  a  day  for  a  whole  family,  is  no  small  under- 
taking and  requires  experience  and  judgment  which  are  best  obtained 
in  our  cooking  schools.  It  is  sincerely  hoped  that  every  girl  will 
take  a  deep  interest  in  matters  of  cooking  and  domestic  economy. 
Every  housewife  should  supply  herself  with  scales  and  follow  the 
general  directions  given  in  the  cooking  recipes  with  precision.  All 
the  quantities  given  are  for  a  family  of  six,  and  reductions  are  made 
accordingly,  rememboring  always  that  hard-working  men  and  nurs- 
ing or  pregnant  women,  and  convalescents  from  acute  diseases,  re- 
quire a  more  liberal  diet.  If,  in  spite  of  good  cooking,  there  should 
be  evidence  in  any  member  of  the  family  of  malnutrition  and  im- 
paired health  it  will  be  well  to  consult  a  physician.  Miss  Cross  is 
entirely  responsible  for  the  following  menus  and  cooking  recipes, 
and  is  entitled  to  the  credit  for  whatever  merit  they  possess: 

MENUS  FOR  WINTER  MONTHS." 


Protein. 

Energy. 

Cost. 

Monday: 

Breakfast— Hominv,  skim  milk,  creamed  hake,  toast,  butter,  coffee.. 
Dinner— Irish  stew' with  dumplings,  boiled  rice,  cold  slaw,  apple  pie. . 

Grams. 
28 
54 
13 

Calories. 

1,053 

1,711 

819 

Cents. 
18 
31 
23 

Total       

96 

3,583 

72 

Tuesday: 

Breakfast— Rice  cakes  (left-over  rice),  kidney  stew,  entire  wheat 

44 

28 
29 

1,176 

842 
1,196 

16 

Dinner— Corned  beef,  boiled  potatoes,  spinach,  tapioca  with  milk 

71 

10 

Total 

101 

8,214 

97 

Wednesday: 

Breakfast— Stewed  prunes,  meat  cakes,  com  bread,  butter,  coffee  — 

Dinner— Split  pea  soup,  braised  beef's  heart,  boiled  cabbage  (corn 

beef  liquor),  boiled  onions,  potatoes,  apricot  roll,  vanilla  sauce 

23 

56 
29 

771 

1,572 
1,002 

27 

44 
18 

Total ... 

108 

3,345 

89 

Thursday; 

Breakfast— Rolled  wheat,  skim  milk,  Potomac  herring,  corn  bread, 
butter  coffee                               .  .................. .  .  ..  .  . 

26 

61 
23 

866 

1,530 
840 

19 

Dinner— Salt  pork,  potatoes,  turnips,  escarolle,  apple  butter,  short 
cake      . 

29 

Supper — Pigs' feet  potato  cakes  bread,  butter,  coffee 

26 

Total 

110 

3,236 

74 

a  For  quantities  of  material  to  be  used  when  not  given  in  cooking  recipes,  see  p.  156. 


152  EEPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSIOIT. 

MENUS  FOR  SUMMER  MONTHS. 


Friday: 

Breakfastr— Oom  flakes,  skim  milk,  salt-water  trout   corn  dodgers, 

coffee 

Dinner— Stewed  tripe,  boiled  potatoes,  stewed  onions,  raw  tomatoes, 

bread,  rice  pudding 

Supper — Beef  stew,  corn  cakes,  butter,  stewed  apples,  tea 

Total 

Saturday: 

Breakfast— Fried  tomatoes,  bacon,  bread,  butter,  coffee 

Dinner—Boiled  leg  of  mutton,  boiled  rice,  green  corn,  summer  squash, 

bread,  gingerbread 

Supper— Cottage  cheese,  baked  potatoes,  raw  onions,  bread,  butter, 

gingerbread,  tea 

Total 

Sunday: 

Breakfast — Boiled  eggs.  Potomac  herring,  corn  bread,  butter,  coffee. 
Dinner — Chartreuse  of  mutton,  tomato  sauce,  boiled  potatoes,  string 

beans,  blackberries,  milk 

Supper— Rice  muffins,  baked  tomatoes,  apple  butter,  coffee 

Total 


Protein.    Energy. 


Grama. 
28 


Calories. 


1,175 

1,035 


35 


120 


3,106 


1,054 
1,014 
1.048 


Cost. 


Cents. 
.26 


.35 

.28 


3,116 


818 

1,187 
1,066 


3,071 


.13 
.97 

.23 


1.33 


23 


56 


COOKING   KECIPES   FOR    WINTEB    MENUS. 

Creamed  hake. — ^After  freeing  2  pounds  of  the  fisli  from  bones  and  skin,  flake 
it,  then  cover  it  with  boiling  water,  put  a  cover  on  the  pan  and  keep  it  on  the 
back  of  the  stove  for  ten  minutes.  Drain  the  water  from  it,  then  pour  cream 
sauce  over  it  and  serve. 

Cream  sauce. — Two  tablespoonfuls  butter,  2  tablespoonfuls  flour,  1  cupful 
milk,  one-half  teaspoonful  salt,  one-eighth  tea  spoonful  pepper.  After  melting 
the  butter  over  steam,  or  on  a  cool  part  of  the  stove,  add  the  flour  and  stir 
over  the  fire  for  one  minute.  Add  the  milk  and  the  mixed  salt  and  pepper,  then 
stir  the  mixture  until  it  thickens,  after  which  cook  over  steam  for  ten  minutes. 
Serve  while  hot. 

Irish  stew  with  dumplings. — One  pound  beef  (brisket),  1  slice  salt  pork,  1 
onion,  4  potatoes.  Cut  the  meat  into  2-inch  pieces,  then  dredge  them  with 
flour  and  brown  them  all  over  in  the  pork  fat  with  the  sliced  onion.  Cover  the 
meat  and  onion  with  boiling  water  and  let  the  mixture  cook  slowly  on  the  back 
of  the  stove.  In  the  meantime  pare  and  dice  the  potatoes  and  boil  them  for  ten 
minutes,  then  drain  the  water  from  them  and  add  them  to  the  stew  when  the 
meat  is  tender.  When  the  potatoes  are  nearly  done,  put  in  the  dumplings, 
pouring  off  the  liquid,  if  necessary,  so  they  will  rest  on  the  potatoes.  Keep  the 
pan  closely  covered  and  let  the  stew  cook  for  ten  minutes.  Take  out  the 
dumplings,  season  the  stew  with  salt  and  pepper,  and  put  it  in  the  center  of  a 
platter,  then  place  the  dumplings  around  the  edge. 

Dumplings. — One  pint  flour,  one-half  teaspoonful  salt,  1  cupful  milk  (scant), 
S  teaspoonfuls  baking  powder.  Make  a  soft  dough  and  flatten  it  out  half  an 
inch  thick,  then  cut  into  small  rounds  or  mix  softer  and  drop  by  the  spoonful 
into  the  hot  stew. 

Cold  slaw. — One-fourth  pound  salt  pork,  4  tablespoonfuls  vinegar,  1  onion,  1 
teaspoonful  salt,  one-third  medium-sized  head  of  cabbage.  Put  the  pork  into  a 
pan  with  half  a  cup  of  water;  let  it  boil  until  the  water  evaporates,  then  cook 
until  the  pork  is  brown  and  crisp.  When  the  fat  is  cool,  add  it  to  the  rest  of 
the  ingredients  and  pour  the  mixture  over  the  thinly  sliced  cabbage. 

Apple  pie. — One  and  one-half  cupfuls  flour,  1  teaspoonful  salt,  8  tablespoon- 
fuls drippings,  about  three-fourths  cupful  ice  water.  After  sifting  the  flour  and 
salt  together  add  the  shortening  and  mix  by  cutting  together  with  a  knife,  add 
the  water  slowly,  still  mixing  with  a  knife,  until  a  dry,  crumbly  paste  is  formed, 
but  all  of  the  flour  is  moistened.  Turn  this  out  on  a  board  without  flour,  and 
after  rolling  it  into  a  thin  sheet  turn  the  paste  around  and  roll  again.  Con- 
tinue this  process  until  the  materials  are  well  blended  and  the  paste  is  smooth. 
Keep  in  a  cool  place  until  it  is  quite  firm.  It  is  better  kept  over  night.  Roll 
out  one-half  of  the  paste  to  fit  the  pie  pan,  cover  this  with  a  layer  of  apples, 


BEPOETS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  153 

which  have  been  cored,  pared,  and  cut  into  thin  slices  across  the  core.  Sprinkle 
with  sugar  and  a  little  cinnamon.  Continue  to  put  in  these  layers  until  the  pan 
is  full,  having  it  higher  in  the  center  than  on  the  sides.  Put  on  a  cover  of 
pastry,  fasten  the  edges  down,  then  trim  the  pie,  holding  the  knife  well  under 
the  plate.  Make  several  openings  on  the  top  for  the  escape  of  steam,  then  bake 
it  in  a  moderately  hot  oven  until  it  is  brown,  about  thirty  minutes.  Remove  it 
at  once  from  the  plate  and  serve  either  hot  or  cold. 

Corn  Bread. — One  pint  meal,  1  teaspoonful  salt,  1  tablespoonful  fat  from 
bacon,  1  teaspoonful  soda,  1  pint  sour  buttermilk.  Pour  over  the  meal  enough 
boiling  water  to  scald  it.  The  meal  must  be  moist,  not  wet.  Add  the  shorten- 
ing, salt,  and  the  soda,  which  has  been  mixed  with  a  little  cold  water.  Stir 
this  until  it  is  thoroughly  mixed,  then  put  in  the  milk.  Bake  it  in  a  quick  oven 
in  shallow  pans  for  about  forty-five  minutes.    Serve  at  once. 

Kidney  stew. — Split  the  kidneys  lengthwise  in  halves  and  trim  off  every  bit 
of  sinew  and  fat  from  the  inside,  then  cut  the  kidneys  into  small  pieces.  Put 
them  into  a  saucepan  and  cover  them  with  cold  water;  then  heat  the  water  until 
it  is  nearly  boiling.  Drain  this  water  off  and  cover  the  kidneys  again  with  cold 
water;  then  heat  the  water  as  before.  Repeat  this,  thus  making  three  treat- 
ments. Be  careful  each  time  that  the  water  does  not  boil  at  all,  or  the  kidneys 
will  be  hard  and  tough.  Discard  all  the  water.  Reheat  the  kidney  in  a  brown 
sauce,  season  it  with  salt  and  pepper,  and  serve  it. 

Brovm  sauce. — Two  tablespoonfuls  butter,  2  tablespoonfuls  flour,  1  cupful 
stock  or  w^ater,  one-half  teaspoonful  salt,  one-eighth  teaspoonful  pepper.  After 
browning  the  butter  add  to  it  the  flour  and  brown  this  mixture,  then  add  the 
stock  or  water  and  stir  until  it  is  thick.  Season  and  add  the  prepared  kidney. 
Serve  at  once. 

To  boil  corn  beef. — Wash  the  meat  well  and  put  it  on  in  cold  water.  Bring 
slowly  to  simmering  point  and  let  it  simmer  thirty  minutes  for  every  pound  of 
meat.  If  the  meat  is  to  be  served  cold  allow  it  to  cool  in  the  liquor  in  which  it 
was  boiled. 

Tapioca  with  milk  and  sugar. — Cover  1  cup  of  flake  tapioca  with  cold  water 
and  let  stand  over  night.  In  the  morning  drain  the  water  from  it  and  add  1 
quart  of  hot  water.  Cook  over  a  slow  fire  until  it  is  quite  transparent,  then 
add  a  pinch  of  salt  and  the  rind  and  juice  of  1  lemon.  Pour  this  into  molds 
which  have  been  wet  with  water  and  keep  in  a  cool  place.  When  firm  turn 
them  out  on  a  platter  and  serve  with  milk  and  sugar. 

Fried  mush. — One  pint  water,  1  teaspoonful  salt,  one-half  cupful  yellow 
meal,  1  egg.  Scatter  the  meal  slowly  into  the  boiling  salted  water,  stirring 
constantly,  then  let  the  mixture  bubble  once  or  twice.  Place  the  pan  over  hot 
water  and  let  it  cook  for  two  hours,  after  which  turn  the  mush  into  a  square 
pan  and  keep  in  a  cool  place  until  it  is  firm.  Cut  it  into  slices  half  an  inch 
thick  and  cover  them  with  the  beaten  egg,  which  has  been  mixed  with  1  table- 
spoonful  of  cold  water.  Cook  these  in  smoking  hot  fat  (enough  to  cover  the 
pieces)  until  they  are  a  golden  brown.     Serve  at  once. 

(Note. — Two  saucepans  may  be  used  for  cooking  the  mush,  the  smaller  one 
resting  on  a  piece  of  wire  gauze  in  the  bottom  of  the  larger  one,  which  contains 
water.  The  fat  used  is  made  from  the  small  pieces  of  fat  meat  which  may  be 
purchased  from  the  butcher  at  2  cents  per  pound.  The  fat  is  strained  and  kept 
in  a  cool  place  for  future  use.) 

Stewed  primes. — After  v^ashing  1  pound  of  prunes,  cover  them  with  cold 
water  and  let  them  stand  for  several  hours.  Put  them  on  the  stove  in  the  same 
water  and  let  them  cook  slowly  until  a  straw  will  go  through  them  easily.  Put 
the  prunes  in  a  dish,  sweeten  the  liquid,  let  it  boil  for  two  minutes,  then  pour 
it  over  the  prunes. 

(Note. — ^AU  dried  fruits  should  be  soaked  in  the  water  before  they  are 
cooked.) 

Meat  cakes. — One  pound  beef,  1  teaspoonful  salt,  one-eighth  teaspoonful 
pepper.  Use  the  lower  part  of  the  round,  which  may  be  purchased  in  some 
markets  for  6  cents  per  pound.  Grind  the  meat  or  have  the  butcher  chop  it 
with  a  cleaver  until  it  is  quite  fine,  then  mix  the  seasoning  with  it,  and  shape 
it  into  small  cakes,  having  the  edge  as  thick  as  the  center.  Put  enough  fat  in 
a  hot  spider  to  keep  the  meat  from  sticking  to  the  pan,  put  in  the  cakes,  and 
shake  the  pan  over  the  fire  until  they  are  brown  all  over.  Now  let  them  cook 
more  slowly,  allowing  seven  minutes  if  they  are  an  inch  thick,  turning  them 
occasionally.  After  taking  out  the  cakes,  put  into  the  pan  1  tablespoonful  of 
drippings  and  the  same  amount  of  flour,  stir  well,  then  add  half  a  cup  of  cold 


164  REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

water  and  cook  until  it  thickens.     Season  with  salt  and  p.epper  and  serve  with 
meat  cakes. 

Split  pea  soup. — One  cupful  split  peas,  6  pints  cold  water,  1  onion,  2-inch  cube 
salt  pork,  2  tablespoonfuls  drippings,  2  tablespoonfuls  flour,  1^  teaspoonfuls 
salt,  one-eighth  tea  spoonful  pepper.  After  picking  over  the  peas,  wash  them 
and  let  them  soak  in  the  cold  water  for  five  or  six  hours.  Add  the  pork  and 
onions,  which  have  been  cut  into  small  pieces  and  cooked  until  they  are  a  light 
brown.  Let  this  mixture  cook  slowly  for  about  four  hours,  after  which  strain 
it,  mix  the  fat  with  the  flour  and  add  to  the  soup,  stirring  constantly  until  the 
mixture  thickens,  then  let  it  cook  for  ten  minutes.    Season  and  serve  at  once. 

Braised  beefs  heart. — After  soaking  the  heart  in  cold  water  for  three  hours, 
remove  the  muscles  from  the  inside  and  the  blood.  Make  a  forcemeat  of  1  cup 
of  bread  crumbs,  2  tablespoonfuls  of  drippings,  1  teaspoonful  of  thyme,  1  table- 
spoonful  of  chopped  celery  tops,  1  teaspoonful  of  onion  juice,  half  a  teaspoonful 
of  salt,  one-eighth  of  a  teaspoonful  of  pepper.  Mix  and  stuff  the  heart.  Tie  it 
together  with  twine,  and  put  it  into  a  pan  which  has  a  close-fitting  cover.  Add 
enough  boiling  water  to  half  cover  the  heart,  put  on  the  lid,  and  cook  in  a  mod- 
erately heated  oven  for  three  hours.  Brown  2  tablespoonfuls  of  fat,  add  2 
tablespoonfuls  of  flour,  and  when  well  mixed,  add  the  water  in  which  the  heart 
was  cooked.  Stir  until  it  thickens,  season  with  salt  and  pepper.  Dish  the 
heart  and  pour  the  sauce  over  it,  then  serve. 

Apricot  roll. — Two  cupfuls  flour,  one-half  teaspoonful  salt,  one-third  pound 
suet,  1  pint  apricots.  Free  the  suet  from  the  fiber  and  skin,  then  chop  it  fine  or 
press  it  through  a  wire  basket.  Mix  this  with  the  flour  and  salt  and  add  gradu- 
ally enough  cold  water  to  make  a  soft  dough.  Roll  it  out  on  a  floured  board  into 
a  sheet  about  an  inch  thick,  spread  the  apricots  thickly  over  the  dough,  roll  it 
up  and  tie  it  in  a  well-flouted  cloth,  leaving  plenty  of  room  for  it  to  swell. 
Put  it  into  a  pot  of  boiling  water  and  boil  for  two  hours,  or  it  may  be  steamed 
two  hours  and  a  half.     Serve  hot  with  vanilla  sauce. 

Vanilla  Sauce. — Two  tablespoonfuls  butter,  2  tablespoonfuls  cornstarch,  one- 
half  cupful  sugar,  1^  cupfuls  water,  1  teaspoonful  vanilla.  After  heating  the 
butter  and  water  to  boiling  point,  stir  in  the  mixed  cornstarch  and  sugar.  Cook 
the  mixture  for  ten  minutes,  then  flavor  and  serve. 

Comed-heef  hash. — One  pint  finely  chopped  beef,  1  pint  boiled  potatoes,  one- 
half  teaspoonful  salt,  one-eighth  teaspoonful  pepper,  2  tablespoonfuls  fat. 
Cut  the  potatoes  into  small  pieces  and  mix  them  with  the  rest  of  the  ingredi- 
ents. Put  this  into  a  heated  spider,  add  enough  hot  water  to  moisten  and  stir 
until  the  mixture  is  well  heated,  then  pack  it  closely  in  the  pan,  cover  it,  and 
let  it  cook  until  it  is  well  browned  on  the  bottom.  Turn  it  out  on  a  platter  and 
serve. 

Apple  butter  short  cake. — One  pint  flour,  1  teaspoonful  salt,  3  tablespoonfuls 
drippings,  2  teaspoonfuls  baking  powder,  milk  or  water  (about  three-fourths 
cup.  Sift  the  flour  with  the  salt  and  baking  powder,  then  add  the  fat,  and  mix 
well.  Pour  in  the  water  slowly,  mixing  with  a  knife  until  a  soft  dough  is  formed. 
Turn  it  out  on  a  floured  board  and,  after  surrounding  it  with  flour,  roll  it  into 
a  thin  sheet  about  half  an  inch  thick.  Cut  it  into  four-inch  squares  and  bake 
them  in  a  quick  oven  until  they  are  a  light  brown,  about  twenty  minutes.  Split 
each  square  and  put  the  apple  butter  between.     Serve  while  hot. 

Pigs'  feet. — After  scraping  a  set  of  four  of  the  feet  soak  them  in  cold  water 
for  several  hours,  then  wash  and  scrub  them.  Split  the  feet  and  put  them  on  in 
cold  water  and  let  them  simmer  until  tender.  Put  them  in  an  earthen  jar,  sea- 
son with  salt  and  pepper,  and  pour  over  them  hot  spiced  vinegar.  They  will  be 
ready  for  use  the  next  day. 

Spiced  vinegar. — Boil  for  one  minute  a  half-pint  of  cider  vinegar,  12  whole 
cloves,  3  inches  of  cinnamon  bark,  and  2  bay  leaves. 

Potato  cakes. — Mash  1  pint  boiled  potatoes,  then  season  them  with  salt  and 
pepper,  and  moisten  with  hot  milk.  Make  into  cakes  and  brown  in  a  pan  with  a 
small  quantity  of  fat     Serve  hot. 

BECIPES   FOB   SUMMEB   MENUS. 

Com  dodgers.— Two  cupfuls  white  meal,  6  tablespoonfuls  skim  milk,  2  table- 
spoonfuls shortening,  1  teaspoonful  salt.  After  scalding  the  meal  with  boiling 
water,  using  just  enough  to  moisten  the  meal,  add  the  shortening  and  stir  until 
it  is  well  mixed,  then  put  in  the  salt  and  milk.  Put  the  mixture  by  spoonfuls 
in  a  large  baking  pan,  flatten  into  small  cakes,  and  keep  them  separate.  Bake 
In  a  moderately  heated  oven  until  brown  on  both  sides,  then  serve. 


REPOETS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  155 

Stewed  tripe. — Two  pounds  boiled  tripe,  2  ounces  salt  pork  (ham  may  be  used) 
one-balf  medium  sized  onion,  1  tablespoonful  chopped  parsley,  1  bay  leaf,  2 
tablespoonfuls  flour,  1  pint  milk,  1  teaspoonful  salt,  one-eighth  tea  spoonful 
pepper.  Cut  the  tripe  into  pieces  about  li  inches  long  and  a  half  inch  wide. 
Dice  the  pork  and  put  in  a  pan  with  the  sliced  onion  and  the  bay  leaf.  Stir 
over  the  fire  until  quite  brown,  then  add  the  flour,  and  when  well  mixed  add  the 
milk.  Stir  this  until  it  is  as  thick  as  ordinary  cream,  after  which  put  in  the 
salt,  pepper,  and  the  tripe,  and  keep  over  a  very  moderate  fire  for  five  minutes. 
Add  the  parsley  and  serve  at  once. 

Rice  pudding. — One-half  cupful  rice,  one-half  cupful  sugar,  1  pinch  of  salt,  1 
quart  of  milk.  After  washing  the  rice  thoroughly,  let  it  soak  in  the  milk  for  half 
an  hour,  after  which  add  the  salt  and  sugar.  Pour  the  mixture  into  a  deep  pan, 
cover  it  and  let  it  bake  about  two  hours,  slowly  at  first,  until  the  rice  has 
softened  and  thickened  the  milk,  then  let  it  brown  slightly.  This  may  be  served 
hot  or  cold. 

Beef  stew. — One  pound  plate  or  brisket,  4  potatoes,  1  teaspoonful  salt,  1 
carrot,  1  tablespoonful  fat,  1  tablespoonful  flour,  one  eighth  teaspoonful  pepper. 
Cleanse  the  meat  by  wiping  it  with  a  damp  cloth  or  by  scraping  it  with  the  back 
of  the  knife.  Cut  it  into  pieces  about  2  inches  square,  and  put  it  into  a  saucepan 
with  the  bones  and  sliced  carrot.  Pour  over  this  enough  boiling  water  to  cover 
well,  about  a  pint  and  a  half,  and  let  it  simmer  until  the  meat  is  tender,  then  add 
the  diced  and  parboiled  potatoes.  When  the  potatoes  are  done,  thin  the  mixed  fat 
and  flour  with  a  little  of  the  hot  liquor  from  the  stew,  and  after  pouring  it 
into  the  stew  stir  it  until  it  thickens  slightly.  Cook  a  few  minutes  longer, 
then  remove  the  bones,  season  and  serve. 

Corn  eakes. — One  pint  meal,  one-half  cupful  flour,  1  pint  sour  buttermilk,  1^ 
teaspoonful  soda,  1  tablespoonful  fat,  1  egg,  1  tablespoonful  salt.  Scald  the 
meal  with  suflicient  boiling  water  to  moisten,  then  put  in  the  fat  and  stir  until 
well  mixed.  When  this  is  cool  add  the  salt,  flour,  and  the  buttermilk.  Stir  in 
the  beaten  egg  and  the  soda,  which  is  mixed  with  a  little  cold  water.  Bake  in 
small  cakes  on  a  lightly  greased  hot  griddle. 

Gingerbread. — One  cupful  molasses,  one-third  cupful  drippings,  1  teaspoonful 
soda,  one-half  teaspoonful  salt,  1  cupful  sour  buttermilk,  1  tablespoonful  ginger, 
3  cupfuls  flour,  1  teaspoonful  cinnamon,  one-half  teaspoonful  allspice.  After 
mixing  the  salt  and  spices  with  the  molasses  add  the  fat,  after  which  add  flour 
and  buttermilk  alternately,  then  beat  until  perfectly  smooth.  Stir  in  the  soda, 
which  is  mixed  with  a  little  cold  watef,  and  partly  fill  greased  gem  pans  with 
the  batter.  Bake  in  a  moderately  hot  oven  about  thirty  minutes  or  until  the 
cakes  are  a  light  brown. 

Chartreuse  of  mutton. — One  cupful  cooked  chopped  mutton,  1  teaspoonful 
chopped  parsley,  one-half  teaspoonful  onion  juice,  1  teaspoonful  lemon  juice, 
one-fourth  teaspoonful  salt,  2  tablespoonfuls  butter,  1  cupful  stock  or  water, 
2  tablespoonfuls  flour,  little  cayenne.  Make  sauce  as  directed  for  cream  sauce, 
then  add  the  rest  of  the  ingredients  and  mix  thoroughly.  Line  a  greased  mold 
with  hot  boiled  or  steamed  rice,  having  the  layer  about  half  an  inch  thick, 
then  fill  the  center  with  the  mutton  mixture  and  cover  the  top  evenly  with 
rice.  Steam  forty-five  minutes,  then  turn  from  the  mold  and  serve  with  tomato 
sauce.  The  greased  mold  may  be  coated  with  bread  crumbs,  then  lined  with 
mashed  potatoes  and,  after  filling  with  the  mutton,  covered  with  potato.    Bake. 

Tomato  sauce. — Two  tablespoonfuls  drippings,  1  cupful  strained  tomatoes, 
2  tablespoonfuls  flour,  one-half  teaspoonful  salt,  one-eighth  teaspoonful  pepper. 
After  melting  the  fat  add  the  flour  and  cook  for  one  minute,  then  add  the 
strained  tomatoes,  the  salt,  and  the  pepper.     Stir  until  it  thickens,  then  serve. 

Scrapple. — Four  pints  water  in  which  the  lamb  was  cooked,  1  pound  scrap 
meat,  3  teaspoonfuls  salt,  1  teaspoonful  thyme,  1  teaspoonful  sweet  marjoram, 
1  pint  meal,  one-fourth  teaspoonful  pepper.  After  cleansing  the  meat,  by 
wiping  it  with  a  damp  cloth,  cut  it  into  small  pieces  and  cook  it  slowly  ih 
the  mutton  broth  until  it  will  easily  separate.  See  that  there  is  one  quart  of 
the  liquid  and  that  the  meat  is  in  very  small  pieces.  Season  the  mixture  of 
water  and  meat,  put  it  on  the  stove  and,  when  it  reaches  boiling  point,  stir  in 
the  meal.  Cook  over  hot  water  for  two  hours,  then  add  the  thyme  and  mar- 
joram and,  when  well  mixed,  turn  it  into  square  pans  and  stand  away  to  cool. 
When  this  is  flrm  cut  it  into  slices  and  brown  in  a  little  fat. 

Rice  muffins. — Two  and  one-fourth  cupfuls  flour,  1  cupful  milk,  three-fourths 
cupful  hot  rice,  1  egg,  5  teaspoonfuls  baking  powder,  2  tablespoonfuls  butter 
or  drippings,  1^  teaspoonfuls  salt.  After  mixing  the  flour  with  the  salt  add 
the  rice,  which  has  been  pressed  through  a  strainer,  and  the  milk  which  is 


156 


REPORTS  OF   THE  PRESIDENT  S   HOMES  COMMISSION. 


mixed  with  the  beaten  yolli  of  the  egg.  Beat  until  the  batter  is  quite  smooth, 
then  add  the  melted  fat,  stir  in  carefully  the  baking  powder  and  then  fold  in  the 
stiffly  beaten  w^hite.  Partly  fill  greased  gem  pans  with  the  batter  and  bake  in 
a  moderately  hot  oven  until  a  light  brow^n,  about  thirty  minutes.     Serve  hot. 

Market  price  of  goods. 


Article. 


WINTER. 

Apples 

Apple  butter 

Bacon  (country) 

Beef: 

Part  of  the  round. 

Brisket  and  plate  . 

Corned 

Beef's  heart 

Beans   

Broken  rice 

Bread  (stale) 

Butter 

Buttermilk 

Cabbage 

Coffee 

Com  flakes 

Cottage  clieese 

Escarolle 

Evaporated  apricots. . . 

Flake  tapioca 

Flour 

Hake 

Hominy 

Kidney  

Meal 


Mutton: 
Breast... 
Fore  leg. 
Neck — 


Unit. 


Quarter  peck 

Jar 

Pound 


do... 

do... 

do... 

do... 

Quart 

Pound... 

Loaf 

Pouixd.. . 
Que  -t. . . . 
He^  i.... 
Pound... 
Package. 

Pint 

Head-... 
Pound... 

do... 

6  pounds 
Pound... 

Quart 

Each 

Pound 

Quart 


Pound. 
....do. 
....do. 


Cost. 


Cents. 
10 


10 


Article. 


Pigs'  feet 

Potomac  herring 

Potatoes  

Prunes 

Rolled  wheat 

Salt  pork 

Saltwater  trout.. 

Sausage 

Skim  milk 

Spinach. 

Split  peas 

Sugar 

Tea 

Tripe 

Turnips 


Apples 

Beets 

Blackberries 

Butter 

Cabbage  

Corn 

Eggs 

Onions 

Potatoes  

Spinach 

String  beans 

Summer  squash . 
Tomatoes 


Unit. 


Set 

Dozen 

Feck 

Pound 

Package 

Pound 

do 

3  pounds 

Quart 

Quarter  peck  . 

Pound 

do 

do 

2  pounds 

Quarter  peck . 


Quarter  peck  . 

3  bunches 

Quart 

Pound 

Head 

Dozen 

-...do 

3  bunches 

Bushel 

Quarter  peck . 

do 

Dozen 

Quarter  peck . 


Cost. 


Cents. 


Quantities  of  materials  to  he  used  for  a  family  of  six  ichen  not  given  in  cooking 

recipes. 


BREAKFAST. 

Uncooked  hominy cupful^_    1 

Skim  milk gills__     3 

Toast loaf__ai 

Butter oimces__°3 

Coffee tablespoonfuls—    4 

Kidney 1 

Stewed  prunes pound__     1 

Rolled  wheat , cupful__    1 

Potomac  herring 3 

Com   flakes , cupfuls-_     2 

Fried  tomatoes. . 8 

Boiled  eggs 12 

DINNER. 

Uncooked  rice . cupfuls__  1^ 

Corned  beef,  for  3  meals pounds_-  8 

Potatoes,  3  in.  long 12 

Spinach peck__  i 

Milk  for  tapioca gills__  3 

Sugar  for  tapioca tablespoonfuls.—  2 

Beef's  heart 1 

Boiled   cabbage head—  \ 

Boiled  onions 6 

Potatoes 6 


«Same  quantity  each  time  used. 


REPORTS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  157 

Salt  pork _-POimd__  * 

Turnips    (mashed) 8 

Potatoes 6 

Escarolle head—  1 

Raw  tomatoes 6 

Leg  of  lamb,  for  3  meals pounds__  7 

Rice cupful—  1 

Corn ears—  12 

Squash i-_ 4 

String  beans peck—  i 

Blackberries quart—  1 

Milk gills—  3 

SUPPER. 

Cottage   cheese pint—  1 

Molasses gills__  3 

Pig's  feet set—  1 

Potatoes 8 

Apples peck__  i 

Cottage   cheese pint—  1 

Potatoes 9 

Onions  (raw) 6 

Tomatoes__— peck__  i 

Apple  butter pint—  i 


Chapter  III. 
THE  CAUSATION  AND  PREVENTION  OF  DISEASE. 

DANGER  PERIODS  IN  LIFE.** 

According  to  a  French  medical  journal  the  annual  mortality  of  the 
entire  human  race  is  33,000,000  persons.  A  fourth  of  the  race  die 
before  completing  their  eighth  year,  and  one-half  before  the  end  of  the 
seventeenth  year,  but  the  average  duration  of  life  is  about  38  to  40 
years.  Not  more  than  one  person  in  100,000  lives  to  be  100  years  old. 
("Medical  Eecord,"  February  27,  1892.) 

During  life  the  fluids  and  tissues  of  the  body  are  constantly  under- 
going changes;  new  matter  is  formed  and  the  old  is  removed  with 
ceaseless  activity.  The  body  is  indeed  a  complex  machine  in  which 
the  law  that  force  is  generated  by  decomposition  is  fully  carried  out. 
Every  motion  of  the  body,  every  pulsation  of  the  heart,  nay,  even 
every  thought,  is  accompanied  by  the  destruction  of  a  certain  amount 
of  tissue.  As  long  as  food  is  supplied  in  sufficient  amount  and  the 
assimilative  functions  are  not  disordered,  reparation  proceeds  as 
rapidly  as  decay,  and  so  long  as  these  two  actions  exactly  counter- 
balance each  other  life  and  health,  unless,  of  course,  in  case  of  acci- 
dent, continues. 

The  human  body  has  been  aptly  likened  to  a  machine,  and  it  is  said 
that  every  machine  has  a  natural  life,  capable  of  doing  just  so  much 
work,  but  after  all  our  machine  differs  from  an  inorganic  machine  in 
the  fact  that  it  possesses  the  power  of  self-repair,  and  also  that  for  a 
given  time,  say  between  birth  and  the  twenty-fifth  year,  our  machine 
increases  in  growth  and  efficiency ;  there  is  then  another  period,  limited 

o Carpenter,  "Cyclopedia  of  Anatomy  and  Physiology,"  Vol.  I,  article  "Age," 
**  Hammond's  Treatise  on  Hygiene." 


158  BEPOBTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION". 

usually  between  the  twenty-fifth  and  thirty-fifth  year,  during  which 
the  living  machine  maintains  its  fullest  development  and  resistance, 
probably  because  regeneration  and  waste  are  exactly  counterbalanced, 
and  then  comes  the  period  of  decline,  reaching  from  the  thirty-fifth 
year  to  the  extreme  limit  of  Imman  life,  when  this  natural  resistance 
begins  to  fail  and  the  tissues  are  not  regenerated  as  fast  as  they  are 
broken  down.     (Hammond.) 

The  various  periods  in  the  life  of  man  are  marked  by  certain  pecul- 
iarities, and  exhibit  susceptibility  to  some  diseases  and  immunity  to 
others. 

Statistics  show  that  out  of  every  1,000  children  born  alive,  188,  or 
over  one-sixth,  perish  before  the  completion  of  the  first  year.  Of  the 
twelve  months  during  the  first  year  of  life  the  first  month  furnishes 
the  highest  mortality.  This  is  due  to  the  fact  that  a  great  many 
children,  imperfectly  developed  at  birth,  die  within  a  few  days;  the 
first  month  is  followed  by  the  second,  third,  and  fourth  month,  prob- 
ably, also,  because  of  diminished  vital  resistance ;  next  by  the  twelfth 
month.  This  jump  from  the  fourth  to  the  twelfth  month  is  quite 
suggestive,  as  it  is  the  usual  period  of  weaning,  with  its  attending 
danger  from  digestive  diseases  incident  to  artificial  feeding. 

During  the  second  and  subsequent  years  the  mortality  gradually 
decreases,  and  of  children  between  the  ages  of  1  and  5  years  there  die 
annually  about  37  out  of  1,000,  making  a  total  loss  during  the  first  five 
years  of  336  out  of  every  1,000  children  bom.  If  we  stop  to  inquire 
into  the  immediate  cause  of  the  excessive  mortality  during  the  first 
twelve  months,  we  find  that  about  40  per  cent  perish  from  diseases  of 
the  digestive  system ;  about  21  per  cent  from  affections  of  the  respira- 
tory organs;  next  in  frequency  are  the  infectious  diseases  like  diph- 
theria, scarlet  fever,  measles,  whooping  cough,  mumps,  tubercular 
affections.  Rickets,  diseases  of  the  nervous  systems,  convulsions,  and 
inflammation  of  the  brain  and  its  membranes  are  also  of  common 
occurrence. 

As  the  age  of  the  child  advances  the  body  becomes  more  fully  de- 
veloped and  better  fitted  to  resist  disease.  The  diseases  to  which  the 
race  is  especially  liable  during  the  period  extending  from  puberty  to 
maturity,  or  about  the  twentj^-fifth  year,  are  those  of  the  respiratory 
organs,  tuberculosis,  appendicitis,  and  typhoid  fever.  Thus  of  500 
cases  of  typhoid  fever  analyzed  by  me,  327  cases  were  between  the  ages 
of  10  and  25  years.  It  has  been  suggested  that  the  undue  prevalence  of 
these  diseases,  as  well  as  of  mental  and  nervous  affections  during  this 
period,  may  possibly  be  connected  with  a  diminished  power  of  resist- 
ance, the  result  of  morbid  sexual  habits. 

The  diseases  which  are  most  frequently  met  with  during  the  period 
of  maturity,  which  ordinarily  extends  from  the  twenty-fifth  to  the 
thirty-fifth  year  of  life,  are  consumption,  gastric  affections,  and 
rheumatism. 

The  period  of  decline  has  been  stated  to  embrace  the  thirty-fifth 
year  to  the  extreme  limit  of  human  life.  This  is  scarcely  exact,  as 
in  the  majority  of  instances  we  observe  a  period  varying  from  five 
to  ten  years,  during  which  the  body  remains  at  a  nearly  fixed  point 
of  development,  before  a  disposition  to  degeneration  is  manifested. 
Indeed,  during  the  first  few  years  of  actual  decay  the  organism  is  so 
slowly  affected  that  very  little  inconvenience  results,  and  occasionally 


BEPOETS   OF    THE  PRESIDENT'S  HOMES   COMMISSION.  159 

Individuals  may  withstand  the  tendency  to  degeneration  to  a  very 
advanced  period  of  existence. 

The  diseases  to  which  the  period  of  decline  is  especially  liable  are 
apoplexy  and  organic  diseases  of  the  heart  and  blood  vessels,  liver, 
and  urinary  organs.  Gout  and  chronic  rheumatism,  pneumonia, 
bronchitis,  and  a  variety  of  nervous  affections  are  also  very  common ; 
while  malignant  diseases,  especially  in  the  female  after  the  cessation 
of  the  menstrual  functions,  are  not  infrequent. 

We  have  not  attempted  to  answer  the  question,  quite  often  asked, 
why  the  body,  after  reaching  a  certain  point  of  development,  ceases 
to  grow.  A  question  equally  interesting  and  difficult  is,  Why  does 
the  body,  after  reaching  maturity,  begin  to  degenerate  ?  It  has  been 
said  by  Hammond: 

If  it  were  possible  to  so  adjust  the  repair  to  the  waste  that  neither  would 
be  in  excess,  there  is  no  physiological  reason  why  life,  if  protected  against 
accidents,  should  not  continue  indefinitely. 

But  as  this,  with  our  present  knowledge,  is  impossible,  we  should 
at  least  direct  our  attention  to  the  removal  of  the  factors  which  here- 
tofore have  interfered  with  the  average  span  of  life  allotted  to  us. 
We  know  that  with  the  advance  of  hygiene  the  average  human  life 
has  been  lengthened  from  eighteen  to  twenty  years  in  the  sixteenth 
century  to  thirty-eight  to  forty  years  and  over  at  the  present  time, 
and  there  is  reason  to  hope  that  we  may  still  further  prolong  our 
existence.  While  much  has  been  accomplished  in  the  past,  more 
remains  to  be  done,  and  one  of  the  pressing  needs  is  an  enlightened 
system  of  dietetics. 

A  long  series  of  investigations  on  tissue  metamorphosis  have  been 
conducted  by  the  Department  of  Agriculture — but  are  now  inter- 
rupted for  lack  of  funds — with  a  view  of  determining  what  substances 
are  necessary  to  repair  a  certain  amount  of  waste.  We  are  extremely 
careful  in  other  machines  to  use  only  those  substances  for  the  genera- 
tion of  force  Avhich  are  proper  and  no  more  than  is  absolutely  neces- 
sary. In  the  human  system  little  attention  is  paid  to  this  question, 
and  we  eat  without  regard  to  the  exact  wants,  and  sooner  or  later 
disorganization  results.  Next,  we  want  to  be  able  to  exercise  all  the 
organs  of  the  body  to  that  extent  only  which  will  insure  their  activity 
and  the  deposit  of  sufficient  new  material  to  keep  them  in  a  state  of 
preservation,  without  leading  to  excess  of  the  process  of  either  re- 
gressive or  progressive  metamorphosis. 

THE   CAUSES   OF  DISEASE. 

The  direct  and  exciting  causes  of  disease  have  been  a  source  of  much 
study.  Thanks  to  the  progress  of  medical  science,  the  field  is  now 
limited  to  certain  chemical,  physical,  mechanical,  and  vital  agencies 
capable  of  producing  definite  alterations  of  the  tissues  and  fluids  of 
the  body  and  manifestations  of  disease.  Among  the  chemical  causes 
we  recognize:  First.  Those  originating  without  the  body  of  an  or- 
ganic an  dinorganic  character,  commonly  known  as  irritants  or 
poisons,  many  of  which  have  been  referred  to  in  connection  with  in- 
dustrial pursuits.  Second.  Those  originating  within  the  body  as  a 
result  of  overeating,  malnutrition,  malfermentation,  and  other  defects 
in  the  physiological  functions  of  the  body.    Some  of  these,  according 


160  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

to  Abbott,'*  include  the  ordinary  end  products,  or  waste  matter  of 
tissue  activity,  that  have  accumulated  within  the  system  as  a  result 
of  defective  accretory  and  excretory  organs;  while  still  others  are 
the  toxic  products  of  malfermentations,  often  in  operation  within  the 
alimentary  tract.  There  is  much  reason  for  believing  that  the  pro- 
tein, when  taken  in  excess  in  the  food,  undergoes  putrefaction,  and 
the  absorption  of  these  products  gives  rise  to  auto-intoxication  by 
rendering  the  blood  current  impure.  Herter,  Comb,  and  others  have 
shown  that  such  a  condition  produces  various  maladies  and  milder 
forms  of  indisposition,  and  MetchnikofF  considers  auto-infection  the 
chief  cause  of  premature  old  age.  Among  the  most  frequent  physical 
causes  of  disease  are  excessive  heat,  cold,  and  moisture.^  while  the 
mechanical  causes  include,  of  course,  accidents  and  injuries  of  every 
description. 

VITAL  CAUSES. 

By  the  term  "  vital  causes  "  we  understand  certain  living  animal 
and  vegetable  parasites  capable  of  reproduction  in  the  body,  and  under 
favorable  conditions  of  producing  manifestations  of  disease.  "  It 
matters  little  whether  the  living  organism  is  large  or  small,  or  belongs 
to  the  vegetable  or  animal  kingdom,  or  whether  it  produces  its  effect 
in  the  skin,  muscle,  lympathics,  internal  organs,  intestines,  or  in  the 
blood,  its  introduction  and  reproduction  constitute  infection." 
(Sternberg.) 

The  writer  does  not  pretend  to  differentiate  between  infectious  and 
contagious  diseases  except  to  indicate  that  all  contagious  diseases  are 
infectious,  but  not  all  the  infectious  diseases  are  contagious.  Small- 
pox, measles,  scarlet  fever,  German  measles,  mumps,  and  chicken  pox 
are  notable  contagious  diseases.  Erysipelas,  pneumonia,  tuberculosis, 
glanders,  and  diphtheria,  while  not  usually  contagious,  may  become 
so  under  favorable  conditions.  Typhoid  fever,  cholera,  yellow  fever, 
and  common  suppuration  are  given  by  Abbott  as  examples  of  non- 
contagious infectious  diseases. 

THE  PREVENTION  OF  INFECTIOUS  DISEASES. 

One  great  peculiarity  of  most  of  the  infectious  diseases  is  that  they 
usually  occur  in  groups,  for  it  rarely  happens  that  isolated  cases  of 
diphtheria,  scarlet  fever,  measles,  etc.,  develop  unless  special  precau- 
tions have  been  taken  to  stamp  out  the  first  cases.  Very  generally  a 
number  of  cases  occur  which  can  be  traced  to  a  common  source  of  in- 
fection, and  the  disease  may  assume  epidemic  proportions.  The  ques- 
tion naturally  arises.  What  constitutes  an  epidemic?  In  other  wcft-ds, 
how  many  cases  are  necessary  before  an  infectious  disease  in  a  com- 
munity with  a  given  population  can  be  said  to  be  epidemic.  Various 
answers  have  been  given.  The  writer  believes  that  a  sudden  and  un- 
due prevMlcnce  of  any  infectious  disease  may  very  properly  be  char- 
acterized as  an  epidemic.  A  disease  is  spoken  of  as  pandemic  when  it 
spreads,  like  influenza  for  example,  over  a  great  extent  of  country — 
affects  groups  of  several  countries  of  the  world  generally.    The  term 

« "  Hygiene  of  Transmissible  Diseases,"   1899,  p.   52. 
»  Kober's  "  Industrial  Hygiene,"  p.  65. 


EEPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  161 

"  endemic  "  is  applied  to  diseases  that  prevail  in  particular  localities 
and  are  influenced  by  local  conditions. 

It  is  in  the  field  of  infectious  diseases  that  hygiene  has  achieved, 
and  doubtless  will  continue  to  achieve,  its  greatest  triumphs,  and  there 
is  ample  room  when  we  contemplate  the  frightful  mortality  from 
these  diseases.  Think  of  the  fact  that  consumption,  during  the  census 
year  1900,  claimed  111,059  victims  in  the  United  States  alone.  Pneu- 
monia caused  105,971  deaths,  diarrheal  diseases  46,907,  typhoid  fever 
35,379,  cholera  infantum  25,576,  influenza  16,645,  diphtheria  16,475, 
croup  12,249,  malarial  fever  14,874,  measles  12,866,  whooping  cough 
9,958,  septicemia  6,776,  scarlet  fever  6,333,  cerebro-spinal  meningitis 
4,174.  In  order  to  appreciate  the  full  significance  of  these  figures  we 
must  consider  not  only  the  mortality,  but  also  the  number  of  cases 
treated.  So,  for  example,  the  35,379  deaths  from  typhoid  fever  in 
one  year  represent  an  annual  prevalence  of  not  less  than  353,790  cases. 
The  duration  of  a  case  of  typhoid  fever  is  not  less  than  thirty  days. 
If  we  calculate  the  average  cost  for  care,  treatment,  and  loss  of  work 
to  be  $300,  and  the  average  value  of  a  human  life  at  $5,000,  we  have  a 
total  loss  of  $283,032,000  per  annum  from  one  of  the  so-called  pre- 
ventable diseases. 

We  know  that  many  of  these  diseases  are  preventable,  and  can  at 
least,  be  checked,  if  not  entirely  stamped  out.  The  decrease  in  the 
death  rate  from  consumption  in  the  United  States  since  1890  amounts 
to  54.9  per  100,000  of  population.  Diphtheria  and  croup,  52.5; 
cholera  infantum,  31.9;  diarrheal  diseases,  19;  typhoid  fever,  12.5; 
malarial  fever,  10.4;  whooping  cough,  3.1;  scarlet  fever,  2.7.  Indeed, 
the  average  age  at  death  in  1890  in  the  United  States  was  31.1;  in 
1900  it  was  35.2  years. 

"  IF     CERTAIN     DISEASES    ARE     PREVENTABLE,    WHY     ARE    THEY     NOT 

PREVENTED?  " 

This  very  pertinent  question  was  asked  some  years  ago  by  the 
Prince  of  Wales,  now  King  Edward,  of  England.  Our  answer  is, 
while  every  scientific  physician  knows  full  well  that  if  the  methods 
of  prevention  recommended  by  sanitarians — including  the  prompt 
disinfection  of  the  dejecta  of  typhoid  fever  patients,  the  expectora- 
tion and  excretions  of  diphtheria,  tuberculosis,  and  pneumonia  pa- 
tients— were  adopted,  these  diseases  would  be  reduced  to  a  minimum, 
and  probably  eradicated  in  the  course  of  a  few  years.  The  facts  are, 
these  recommendations  have  not  been  generally  adopted  because  the 
knowledge  gained  by  experimental  medicine  is  not  sufficiently 
diffused.  Nor  is  the  medical  profession  responsible  for  the  fact  that 
so  many  States  still  permit  every  charlatan  to  practice  one  of  the 
most  difficult  and  responsible  of  all  professions,  without  a  rigid  sys- 
tem of  examination.  So  long  as  we  recognize  and  employ  irregular 
and  incompetent  practitioners,  so  long  will  infectious  diseases  be 
spread  as  the  result  of  ignorance  and  neglect. 

The  public  should  be  made  familiar  with  the  nature  and  causes  of 
infectious  diseases,  and  be  taught  that  many  are  a  source  of  danger 
against  which  it  is  entitled  to  be  warned.  The  health  department 
should  have  competent  medical  inspectors  and  a  clinical  laboratory 
for  the  verification  of  the  diagnosis.     It  should  have  the  power,  in 

S.  Doc.  644,  60-2 12 


162  REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

certain  of  these  diseases,  to  display  warning  signs,  to  enforce  isola- 
tion and  disinfection,  and  to  take  such  other  steps  in  the  way  of  pre- 
vention as  may  be  deemed  necessary  to  limit  their  spread. 

Isolation  to  be  effective  should  extend  to  all  persons  who  have  come 
in  intimate  contact  with  the  patient.  This  is  rarely  enforced,  except 
in  smallpox,  in  the  case  of  the  wage-earners  of  the  family,  but  it  is 
clearly  their  duty  to  take  special  precautions  in  the  way  of  clothing 
and  personal  disinfection. 

Since  our  knowledge  of  the  nature  of  infectious  diseases  has  been 
more  and  more  defined,  scientific  methods  for  their  prevention  have 
been  applied.  We  have  learned,  too,  that  in  addition  to  the  germ 
there  must  be  a  suitable  soil  for  its  proliferation  and  that  sanita- 
tion should  not  only  destroy  the  environment  for  its  development 
without  the  body,  but  also  place  the  system  in  the  best  possible  con- 
dition to  resist  its  poisonous  action.  In  the  way  of  individual  efforts, 
all  measures  which  will  improve  the  tone,  nutrition,  and  vital  powers 
of  the  system,  many  of  which  have  been  alluded  to  in  the  preceding 
pages,  can  not  fail  to  render  us  less  susceptible  to  infection.  Nor 
should  we  underrate  the  importance  of  preventive  inoculations,  for 
it  must  be  remembered  that  smallpox,  for  example,  would  continue 
to  carry  off  one-tenth  of  the  population  and  disfigure  another  tenth 
if  it  were  not  for  the  protective  influence  of  vaccination. 

The  diseases  which  deserve  special  preventive  efforts  on  account  of 
their  undue  prevalence  are  consumption,  pneumonia,  scarlet  fever, 
diphtheria,  typhoid  fever,  diarrhea,  and  dysentery.  .  During  the  prev- 
alence of  the  last  three  diseases,  and  especially  when  the  water  is 
regarded  with  suspicion,  the  safest  plan  is  to  boil  the  drinking  water 
and  bring  the  milk  to  the  boiling  point.  While  the  general  rules  of 
hygiene  are  necessary  at  all  times,  they  are  especially  indicated 
during  the  prevalence  of  epidemics.  A  simple  life,  hope  and  courage, 
avoidance  of  excesses,  of  overwork,  fear,  and  anxiety  will  serve  to 
maintain  a  natural  power  of  resistance  to  infection. 

If  in  spite  of  all  precautions,  including,  of  course,  avoidance  of 
sources  of  infection,  contagious  diseases  should  gain  a  foothold  in  the 
family,  the  advisability  of  hospital  treatment  ought  to  be  seriously 
considered.  The  advantages  from  every  point  of  view  are  in  favor 
of  such  a  course,  especially  when  we  consider  the  danger  of  infection 
to  other  members  of  the  family. 

SICK  ROOM,  CARE  AND  DISINFECTION. 

If  the  patient  is  treated  at  home,  a  bright,  quiet,  and  cheerful  room 
should  be  chosen,  and  promptly  stripped  of  carpets  and  unnecessary 
furniture.  It  is  in  just  such  instances,  when  the  importance  of  simple 
furniture,  oiled  or  waxed  floors,  avoidance  of  draperies,  dust  and 
germ  traps  gain  special  significance.  It  is  needless  to  insist  that  the 
room  must  be  kept  properly  ventilated. 

In  the  light  of  our  knowledge  it  is  certainly  our  duty  to  tell  the 
family,  in  typhoid  cases,  that  the  infectious  matter  is  contained  in  the 
excreta,  and  must  be  destroyed  for  the  protection  of  others.  In  like 
manner  we  should  not  hesitate  to  inform  a  consumptive  and  his 
friends  that  the  germs  of  the  disease  are  contained  in  the  expectora- 
tions; how  they  may  be  conveyed  to  others  in  coughing,  kissing,  and 


REPOKTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  163 

dried  sputum,  and  how  they  should  be  destroyed.  And  so  we  might 
go  through  the  list  of  infectious  diseases. 

Scientific  disinfection  had  its  inception  with  the  labors  of  Koch 
and  Sternberg  in  1880.  Although  certain  physical  and  chemical 
agents  were  used  empirically  for  ages,  now  we  know,  from  laboratory 
experiments,  that  they  are  effective,  because  they  destroy  the  vitality 
of  the  germs.  We  also  know  that  in  most  of  the  contagious  diseases 
the  infective  matter  is  given  off  by  the  patient  chiefly  through  the 
secretions  and  excretions,  and  it  is  evident  that  disinfection  to  be  of 
value  must  be  directed  to  these  and  all  the  media  with  which  the 
patient  has  come  in  contact. 

A  small  gas  stove  near  the  sick  room,  and  a  4-gallon  wash  boiler 
in  which  napkins,  soiled  linen,  or  clothing  can  be  boiled,  and  thus 
disinfected  before  being  laundered,  will  protect  other  inmates.  The 
use  of  separate  eating  and  drinking  utensils,  which  can  be  boiled 
in  a  weak  soda  solution,  is  also  a  necessary  precaution. 

The  refuse  of  meals  should  be  placed  in  a  covered  vessel  containing 
a  disinfectant  solution  (IJ  tablespoonfuls  of  lysol  to  1  quart  of 
water).  A  similar  solution  may  be  used  to  wipe  the  floor,  furniture, 
and  door  knobs.  Clinical  thermometers,  tongue  depressors,  and  other 
instruments  should  be  kept  in  a  disinfectant  solution  and  rinsed  off  in 
warm  water  before  using. 

The  stools,  vomited  matter,  expectorations,  urine,  blood  and  pus  of 
infectious  patients,  especially  those  suffering  from  typhoid  fever, 
dysentery,  cholera,  tuberculosis,  pneumonia,  influenza,  diphtheria, 
and  scarlet  fever,  should  be  placed  in  a  covered  vessel  containing  the 
germicidal  solution  to  be  hereafter  described,  the  whole  to  be  thor- 
oughly mixed  and  allowed  to  stand  for  one  hour  before  throwing  the 
contents  into  water  closets  or  privy  vaults.  Disinfection  is  also  indi- 
cated in  diseases  like  typhus  fever,  cerebro-spinal  meningitis,  small- 
pox, anthrax,  glanders,  and  j^ellow  fever ;  in  the  latter  disease  chiefly 
for  the  destruction  of  mosquitoes.  It  would  also  be  well  to  resort  to 
disinfection  in  all  the  early  cases  of  measles,  whooping  cough,  doubt- 
ful cases  of  fever,  and  diarrheal  affections. 

In  diseases  like  smallpox  and  scarlet  fever,  in  which  the  infectious 
agent  is  given  off  most  likely  from  the  surface  of  the  body,  occasional 
sponging  with  dilute  chlorinated  soda  solution,  1  part  to  9  of  water, 
has  been  recommended,  or  the  body  may  be  anointed  with  some  harm- 
less antiseptic  ointment ;  while  during  convalescence,  i.  e.,  just  before 
the  patient  mingles  with  others,  a  corrosive  sublimate  bath,  3  drachms 
to  30  gallons  of  water,  is  indicated.  Infectious  corpses  should  not 
be  washed,  but  enveloped  at  once  in  a  sheet  saturated  with  a  5  per 
cent  solutioa  of  carbolic  acid  or  bichloride  solution,  2  drachms  to  a 
gallon  of  water. 

All  worthless  articles  should  be  burned.  Metallic  bodies  may  be 
sterilized  b}^  exposure  to  red  heat  or  boiling.  A  good  solution  for 
soiled  body  and  bed  clothing  is  made  of  carbolic  acid  3  parts,  com- 
mon soft  soap  2  parts,  and  cold  water  100  parts;  they  should  soak 
for  two  hours,  when  they  may  be  rinsed  and  sent  to  the  laundry. 
Valuable  clothing,  mattresses,  carpets,  and  draperies  should  be  sub- 
jected to  disinfection  in  a  special  apparatus  furnished  by  the  health 
department,  and  in  the  absence  of  such  facilities  they  should  be  hung 
up  loosely  in  the  room  and  subjected  to  the  influence  of  formaldehyde 


164  REPORTS  OP  THE  PRESIDENT'S  HOMES  COMMISSION. 

gas,  which  has  also  been  found  the  most  effective  agent  for  room 
and  house  disinfection  after  the  recovery,  death,  or  removal  of  pa- 
tients, and  is  usually  conducted  by  agents  of  the  health  office.  A 
cheerful  compliance  with  the  rules  and  regulations  of  this  service 
can  not  fail  to  be  a  benefit  to  the  family  and  public  at  large.  If  such 
a  department  does  not  exist,  if  becomes  the  duty  of  the  attending 
physician  to  see  that  the  premises  are  properly  disinfected.  For  this 
purpose  it  is  necessary  to  make  the  apartments  as  nearly  air-tight 
as  possible,  and  to  generate  either  formaldehyde  by  the  combustion 
of  wood  alcohol  or  liberate  it  from  formalin.  The  room  must  be  kept 
closed  for  six  hours  after  fumigation  and  it  should  then  be  thor- 
oughly aired  and  exposed,  when  practicable,  to  sunlight,  which  is  in 
itself  a  very  efficient  germicide. 

The  report  of  the  committee  on  public  health  of  the  Medical 
Society,  District  of  Columbia  ("  Washington  Medical  Annals," 
January,  1908),  shows  that  there  has  been  a  marked  reduction  in 
the  mortality  of  diphtheria,  measles,  and  scarlet  fever  during  the  past 
ten  years  in  the  American  cities,  coincident  with  the  establishment 
of  municipal  quarantine  and  disinfection.  The  average  reduction 
in  the  mortality  from  diphtheria  in  10  cities  amounted  to  24.4  per 
cent.  While  in  this  disease  the  use  of  antitoxin  has  served  to  accom- 
plish the  result,  the  reduction  of  44  per  cent  in  the  mortality  from 
measles  and  a  reduction  of  70.8  per  cent  in  the  mortality  of  scarlet 
fever  must  be  largely  attributed  to  preventive  efforts,  including,  of 
course,  higher  standards  of  living. 

In  this  connection  the  early  use  of  diphtheria  anitoxin  should  be 
emphasized.  The  average  diphtheria  mortality,  where  antitoxin  was 
used,  in  Chicago  in  1902  was  6.48  per  cent,  and  where  not  used  it 
was  32.5  per  cent ;  the  mortality  in  children  when  used  upon  the  first 
day  was  only  1.45  per  cent,  but  when  used  later  than  the  fourth  day 
it  rose  to  14.49  per  cent. 

Space  will  not  permit  a  detailed  statement  of  other  triumphs  in 
preventive  medicine,  but  the  fact  that,  according  to  Surgeon-General 
Wyman  of  the  Public  Health  and  Marine-Hospital  Service,  there  were 
during  the  last  eight  years  242,847  cases  of  smallpox  with  6,067  deaths 
in  the  United  States  prompts  the  suggestion  that  every  death  from 
smallpox  is  a  disgraceful  reflection  upon  the  intelligence  of  the  age. 
This  disease  is  entirely  preventable  by  vaccination  and  proper  re- 
vaccination.  The  statistics  of  England  show  that  in  the  last  half 
of  the  eighteenth  century  out  of  every  1,000  deaths  from  all  causes  96, 
or  nearly  one-tenth,  perished  from  smallpox.  On  the  14th  of  May, 
1796,  Edward  Jenner  introduced  vaccination.  During  the  period  of 
optional  vaccination  the  death  rate  fell  from  200  to  41.-^  per  100,000 
of  population,  and  from  1850  to  1898,  during  a  period  of  compulsory 
vaccination,  it  fell  to  5.3.  In  August,  1898,  the  "  conscientiously 
believes  "  clause  was  inserted  in  deference  to  the  anti- vaccinationists ; 
230,147  persons  were  exempted  by  the  operation  of  the  law,  and  in 
1902  the  rate  rose  in  Scotland  to  7.5,  and  in  the  United  Kingdom 
to  6.1  per  100,000.  The  statistics  of  Prussia  show  that  with  the  en- 
actment of  the  revaccination  law  in  1874  the  mortality  has  fallen 
to  less  than  one-tenth  per  100,000  of  population,  while  the  rate  in 
the  registration  area  in  the  United  States  is  just  34  times  greater. 
Indeed,  it  is  claimed  that  Prussia  would  be  entirely  free  from  the 


REPORTS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  165 

disease  were  it  not  for  the  importations  from  Eussia  and  Austria. 
President  Thomas  Jeiferson  was  instrumental  in  introducing  vacci- 
nation in  1801  in  the  South,  and  in  1806,  according  to  Harrington, 
wrote  the  following  letter  to  Doctor  Jenner : 

You  have  erased  from  the  calendar  of  human  afflictions  one  of  its  greatest. 
Yours  is  the  comfortable  reflection  that  mankind  can  never  forget  that  you 
have  lived.  Future  nations  will  know  by  history  alone  that  the  loathsome 
smallpox  has  existed  and  by  you  has  been  extirpated. 

It  is  to  be  regretted  that  these  prophetic  words  should  not  have  been 
fulfilled  in  this  country  of  progress  and  enlightenment.  With  the 
introduction  of  glycerinated  animal  lymph  every  vestige  of  prejudice 
against  vaccination  should  cease,  and  compulsory  laws  should  be 
enacted  in  every  State,  so  that  smallpox  here,  as  in  the  German  army, 
may  become  practically  unknown.  While  quite  a  number  of  States 
have  enacted  laws  requiring  that  un vaccinated  children  shall  not  be 
admitted  to  the  public  schools,  the  undue  prevalence  of  the  disease 
indicates  that  these  laws  are  not  rigidly  enforced. 

TUBERCULOSIS  OR  CONSUMPTION. 

The  total  number  of  deaths  reported  as  due  to  consumption  in  the 
United  States  during  the  census  year  of  1900  was  109,750,  of  which 
53,626  were  males  and  56,124  were  females.  Statistics  also  show  that 
the  death  rate  from  this  disease  in  1900  was  highest  in  the  District  of 
Columbia.  As  a  matter  of  fact,  according. to  the  records  of  the  health 
office  during  the  past  thirty  years,  14.5  per  cent  of  all  the  deaths 
occurring  in  the  District  of  Columbia  have  been  caused  by  pulmonary 
tuberculosis.  The  death  rate,  however,  has  gradually  and  constantly 
improved  and  has  fallen  from  4.5  per  1,000  inhabitants  in  1878  to  2.3 
in  1907.  This  decline,  we  believe,  is  almost  entirely  due  to  improved 
methods  in  general  sanitation  and  higher  standards  of  living,  which 
have  increased  the  natural  power  of  resistance  to  the  disease.  The 
decline  in  the  death  rate  of  the  white  race  during  this  period  has  been 
from  3.3  in  1878  to  1.3  in  1907,  and  for  the  colored  race  from  6.9  to 
4.5  during  the  same  period.  An  emphasis  is  given  to  the  comparison 
of  the  death  rates  of  the  two  races  when  we  realize  that  the  average 
colored  population  of  the  District  during  the  past  thirty  years  was 
about  31.8  per  cent  of  the  entire  population.  In  other  words,  31.8  per 
cent  of  the  population  has  furnished  over  54  per  cent  of  deaths  from 
pulmonary  consumption  since  1878.  There  were  9,534  deaths  from 
this  disease  during  the  past  twelve  years  in  this  city — 4,266  white  and 
6,268  colored. 

Consumption  not  only  leads  the  list  of  diseases  in  order  of  frequency 
and  mortality,  but  the  pecuniary  losses  entailed  by  the  long  duration 
of  the  disease  and  the  danger  to  others  from  infection  renders  the 
subject  of  importance  from  an  economic  as  well  as  medical  point  of 
view.  If  we  assume  the  average  duration  of  the  disease  to  be  two 
hundred  days,  and  that  $2  per  day  is  expended  for  treatment,  care, 
and  loss  of  work,  the  9,534  deaths  in  twelve  years  involved  a  total 
financial  loss  to  the  community  of  $3,813,600,  or  an  average  of 
$317,800  per  annum. 

The  classical  researches  of  Koch  have  established  beyond  a  doubt 
that  the  disease  is  caused  by  the  growth  and  multiplication  in  the 


166  REPORTS  OP  THE  PRESIDENT'S  HOMES  COMMISSION. 

body  of  man  or  animal  of  a  living  microscopic  organism  or  vegetable 
cell  called  the  tubercle  bacillus. 

The  mere  introduction  does  not  necessarily  cause  disease,  as  the 
system  possesses  certain  defensive  forces,  and  if  the  tissue  cell  hap- 
pens to  be  stronger  than  the  microbial  invader  no  liarm  results.  If, 
on  the  other  hand,  the  conditions  of  the  system  favor  the  growth  and 
development  of  the  germ,  little  tumor-like  knots  are  formed,  known 
as  tubercles  or  tubercular  deposits.  These,  if  formed  in  the  lungs, 
may  soften  and  break  down  and  are  coughed  up.  Heller  calculates 
that  7,200,000,000  of  bacilli  may  be  expectorated  in  twenty- four 
hours  by  a  single  patient. 

The  disease  most  commonly  affects  the  lungs,  but  may  also  affect 
the  glands,  intestinal  and  other  internal  organs ;  also  the  skin,  mucous 
membranes,  bones,  joints,  and  the  membranes  of  the  brain. 

The  bacillus  has  been  found  in  all  tubercular  deposits  in  man  and 
animals,  and  the  most  frequent  source  of  infection  is  conveyance  from 
man  to  man,  while  the  possibility  of  transmission  from  animals  to 
man  can  not  be  ignored. 

The  germs  may  enter  the  system  by  the  respiratory  and  alimentary 
passages,  and  by  the  skin  and  mucous  membranes  if  there  is  an 
abrasion.  The  tubercle  bacilli  have  not  yet  been  demonstrated  in  the 
soil,  water,  or  atmosphere,  except  in  the  immediate  vicinity  of  a  con- 
sumptive. Cornet  demonstrated  their  presence  in  the  dust  of  rooms 
and  hospitals  inhabited  by  consumptives  in  40  of  the  147  samples 
examined.  Since  the  brea.th  of  tuberculous  patients  does  not  con- 
tain the  germs,  we  may  assume  that,  when  found  in  rooms,  they 
originate  from  the  material  coughed  up  by  persons  and  carelessly 
expectorated  upon  the  floor,  walls,  or  carpet,  which  material,  after 
drying,  becomes  a  constituent  of  the  household  dust. 

It  has  also  been  shown  by  the  classical  investigations  conducted 
under  Professor  Fluegge  that  about  80  per  cent  of  consumptives  may 
in  coughing,  sneezing,  and  talking  project  into  the  air  little  droplets 
infected  with  tubercle  bacilli,  withm  a  distance  of  2  to  3  feet  from 
the  patient ;  and  that  these  droplets  constitute  a  source  of  danger,  as 
they  may  be  inhaled  in  a  fresh  and  virulent  state,  especially  if  pa- 
tients fail  to  guard  against  this  mode  of  spreading  by  the  use  of 
handkerchiefs  held  before  their  mouths.  It  is  believed  that  this 
mode  of  spreading  infection  also  operates  to  a  great  extent  in  in- 
fluenza and  infectious  catarrh  of  the  respiratory  passages,  sore 
throats,  diphtheria,  etc.  Fluegge,  without  wishing  to  exaggerate  the 
danger  from  droplet  infection,  believes  it  to  be  greater  than  from  the 
inhalation  of  infected  dust.  He  very  properly  emphasizes  the  sources 
of  infection  from  fresh  dried  sputum  on  floors,  handkerchiefs,  cloth- 
ing, towels,  etc.,  and  it  is  perfectly  conceivable  that  the  germs  may 
likewise  be  conveyed  by  small  particles  of  sputum  in  kissing,  in  in- 
strumental manipulations,  or  by  adhering  to  eating  and  drinking 
utensils  in  common  use.  There  is  much  reason  to  believe  that  the 
germs  may  be  conveyed  in  clothing  from  carelessly  expectorated 
sputum.  Perlen  tells  us  that  of  4,177  tuberculosis  subjects  treated  in 
the  Munich  Poliklinik,  709  were  engaged  in  tailoring,  cleaning,  and 
shoe  shops. 

Tubercle  bacilli  have  been  found  in  the  milk  of  tuberculous  mothers 
and  cows,  especially  when  the  lacteal  glands  were  the  seat  of  the 
disease  or  the  system  was  infected  with  general  tuberculosis;  they 


REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  167 

have  also  been  found,  under  certain  conditions,  in  the  flesh  of  animals, 
and  in  the  blood,  feces,  and  urine  of  affected  persons.  Milk,  cream, 
butter,  ice  cream,  and  dairy  products  may  contain  tubercle  bacilli  if 
the  product  is  derived  from  an  infected  cow. 

Professor  Koch's  views  on  this  subject  are  in  substance  as  follows: 

1.  The  tubercle  bacilli  of  bovine  tuberculosis  are  different  from 
those  of  human  tuberculosis. 

2.  Human  beings  may  be  infected  by  bovine  tubercle  bacilli,  but 
serious  diseases  from  this  cause  occur  very  rarely. 

3.  Preventive  measures  against  tuberculosis  should,  therefore,  be 
directed  primarily  against  the  propagation  of  human  tubercle  bacilli. 

His  opponents,  on  the  other  hand,  believe  that  the  danger  from  the 
transmission  of  bovine  tuberculosis  is  considerable,  and  infection  by 
the  intestinal  route  may  not  only  produce  tuberculosis  of  the  bowels, 
peritoneum,  and  lymphatic  glands,  but  also  of  the  lungs.  Much  re- 
mains to  be  done,  however,  to  determine  the  real  degree  of  danger 
from  bovine  tuberculosis. 

According  to  Doctor  Salmon,  during  the  year  1900,  of  4,186,166  in- 
spected cattle  in  the  United  States,  5,279,  or  1  in  921,  were  tubercu- 
lous, and  of  23,336,884  hogs,  5,444  were  sufficiently  affected  to  cause 
contamination  of  some  part  of  the  carcass.  The  writer  has  tabulated 
86  cases  of  milk-borne  tuberculosis,  3  accidental  inoculations  in  man 
by  the  topical  application  of  cream  and  milk,  and  12  tuberculosis 
wound  infections  in  veterinarians  and  butchers. 

The  possibility  that  the  germs  of  tuberculosis  may  be  carried  by 
means  of  flies  and  dust  suggests  that  greater  precaution  be  exercised 
in  the  exposure  of  foodstuff's  in  show  windows  and  markets.  Other 
modes  of  infection,  such  as  by  the  mucous  membranes  of  the  eye,  geni- 
tals, wounds,  and  even  through  the  unbroken  skin,  have  been  reported. 
There  is  little  or  no  evidence  to  show  that  the  disease  is  ever  inherited, 
but  we  may  assume  that  in  children  of  consumptive  parents  we  are 
dealing  with  the  transmission  of  vulnerable  anatomical  elements,  and 
this,  together  with  the  fact  that  they  are  constantly  exposed  to  the 
germs,  renders  them  peculiarly  liable  to  the  disease. 

From  what  has  been  said  it  is  evident  that  the  tubercle  bacilli  are 
widely  scattered;  the  modes  of  invasion  are  also  numerous;  and  yet 
there  is  a  certain  proportion  of  those  exposed  who  do  not  contract  the 
disease.  This  shows  that  in  addition  to  the  germ  there  must  also  be 
a  suitable  soil  for  its  growth  and  development.  Such  a  soil  is  usually 
found  in  persons  of  feeble  physique,  victims  of  malnutrition,  whose 
bodies  have  been  weakened  from  any  one  or  more  of  numerous  causes, 
whether  it  be  a  previous  attack  of  sickness,  loss  of  sleep,  dissipation, 
morbid  habits,  insanitary  houses,  lack  of  pure  air,  cleanliness,  sunlight 
and  outdoor  exercise  or  of  proper  food. 

Clinical  experience  indicates  that  faulty  nutrition,  debility,  loss  of 
blood,  anemia,  mental  anxiety,  diabetes,  whooping  cough,  measles, 
and  other  diseases  favor  the  development  of  tuberculosis.  We  also 
know  that  a  predisposition  may  be  mherited,  as  evidenced  by  a  deli- 
cate physique,  narrow  chest,  and  general  vulnerability  of  the  tissues. 
A  vulnerability  of  the  tissues  to  the  disease  may  also  be  acquired  by 
dust- producing  occupations,  and  here  the  amount  of  dust  seems  less 
important  than  the  character  of  the  particles  which  compose  it.  For 
this  reason,  no  doubt,  the  hard,  sharp,  and  angular  particles  of  iron 


168  REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION, 

and  slone  dust  are  more  liable  to  produce  injuries  of  the  respiratory 
passages,  thus  favoring  the  invasion  of  the  bacilli. 

Uffelmann  believes  that  what  we  call  inherited  or  acquired  predis- 
position to  tuberculosis  may  amount,  in  many  instances,  only  to  a 
local  susceptibility  of  the  respiratory  passages,  a  weakness  of  the 
membranes,  and  greater  vulnerability,  and  refers  to  the  fact  that 
some  individuals,  otherwise  healthy,  show  a  greater  liability  to  laryn- 
geal and  bronchial  catarrhs,  and  later  to  tuberculosis,  whilst  in  others 
repeated  attacks  of  tonsilitis  predisposes  to  diphtheria. 

The  observations  of  Doctor  Bowditch,  of  Boston,  and  Doctor 
Buchanan,  of  England,  indicate  that  damp  soils  and  habitations  are 
important  predisposing  causes  to  tuberculosis,  and  we  know  posi- 
tively that  a  decided  reduction  has  been  observed  everywhere  coinci- 
dent with  the  introduction  of  sewers.  The  only  reasonable  explanation 
is  that  sewers  have  helped  to  purify  the  air,  and  rendered  otherwise 
damp  soil  and  houses  dry  and  more  healthful.  It  is  well  known  that 
a  damp  soil  is  liable  to  make  a  house  damp  by  a  capillary  attraction, 
and  the  injurious  effects  of  damp  air  have  already  been  pointed  out 
on  page  104.* 

As  in  other  infectious  diseases,  the  question  as  to  whether  the  germs 
are  introduced  directly,  and  in  sufficient  numbers,  is  of  importance. 
The  observations  of  Humphrey,  Pollock,  and  Leudet  conclusively 
show  that  in  well-ventilated  wards  of  chest  and  consumption  hos- 
pitals the  disease  is  not  usually  found  to  spread.  In  private  practice 
the  results  are  different.  A  French  committee  of  investigation  pre- 
sents 213  cases  of  tuberculosis  in  which  the  communicability  of  the 
disease  was  clearly  established.  In  64  of  these  cases  the  disease  was 
conveyed  from  husband  to  wife ;  in  43  from  the  wife  to  the  husband ; 
in  38  it  was  transmitted  to  brothers  or  sisters ;  in  19  from  parents  to 
the  children;  in  16  to  distant  relatives;  and  in  32  to  outsiders.  The 
communicability  was  most  marked  among  the  poorer  classes.  Another 
collective  investigation,  by  a  German  medical  society,  revealed  the 
fact  that  of  938  married  persons  who  died  of  acquired  tuberculosis, 
in  101  instances  either  the  husband  or  the  wife  also  contracted  the 
disease.  In  8.1  per  cent  of  these  cases  the  husband  contracted  the 
disease  from  his  wife,  and  in  13.2  per  cent  the  wife  was  infected 
from  the  husband.  Other  statistics  might  be  adduced  in  favor  of  the 
communicability  of  the  disease,  but  Zasetzlcy's  observation  is  of  spe- 
cial interest.  He  reports  the  case  of  a  tuberculous  woman  who  mar- 
ried, between  1872  and  1883,  3  husbands,  all  previously  healthy; 
the  first  husband  died  in  1879  of  tuberculosis ;  the  second  in  1881,  and 
the  third  husband,  at  the  time  of  the  report  in  1884,  was  also  a 
victim  of  the  disease,  the  wife  in  the  meantime  having  died  of 
consumption. 

We  can  only  explain  the  greater  contagiousness  in  such  cases  by  a 
more  intimate  contact,  the  occupation  of  the  same  room  and  bed, 
common  use  of  eating  and  drinking  utensils,  mouth  to  mouth  contact, 
and  the  vitiated  and  infected  air  of  private  rooms. 

KABLT  SYMPTOMS  OF  CONSUMPTION. 

The  early  symptoms  are  by  no  means  clearly  defined;  we  have, 
however,  a  steady  loss  in  weight,  with  a  slight  amount  of  fever, 

•  Kober's  Industrial  Hygiene. 


BEPORTS   OP   THE  PRESIDENT'S  HOMES  COMMISSION.  169 

especially  in  the  afternoon  or  evening ;  the  heart's  action  is  quickened 
upon  the  slightest  exertion,  there  is  a  general  feeling  of  progressive 
weakness,  with  loss  of  appetite  or  disturbed  digestion.  There  may- 
or may  not  be  a  cough  in  the  early  stage  of  the  disease.  The 
symptoms  referred  to  are  sufficiently  serious  to  call  for  the  advice 
of  a  physician,  and  should  never  be  neglected.  Every  child  should 
learn  to  know  that  prompt  treatment  in  the  incipient  stage  offers 
the  best  chances  for  recovery,  and  that  by  proper  care  80  per  cent 
may  be  permanently  cured. 

Consumption  is  a  curable  disease,  and  the  chief  remedies,  such  as 
fresh  air,  wholesome  food  and  living  quarters,  suitable  clothing, 
systematic  bathing  and  hardening  of  the  skin,  are  also  the  best  pre- 
ventive measures.  Patients  should  not  waste  money  on  patent  medi- 
cines or  advertised  cures  for  consumption.  No  reputable  physician 
ever  advertises  his  skill,  and  persons  unable  to  pay  for  medical 
services  will  always  find  competent  men  at  the  dispensaries. 

PREVENTION    OF   TUBERCULOSIS. 

The  facts  presented  in  the  foregoing  pages  justify  the  following 
conclusions : 

1.  Tuberculosis  is  an  infectious  disease  caused  by  a  microbe,  trans- 
missible to  healthy  persons  under  certain  favorable  conditions. 

2.  Inherited  and  acquired  predisposition  play  an  important  role 
in  the  invasion  and  multiplication  oi  the  bacilli. 

3.  The  germs  may  enter  the  system  by  the  respiratory  and  alimen- 
tary passages,  and  by  the  skin  and  mucous  membranes,  if  there  be 
an  abrasion. 

4.  'V^^iile  the  bacillus  may  be  transmitted  through  the  milk,  flesh, 
and  blood  of  animals  and  man,  the  most  common  and  effective  way  of 
distributing  the  disease  is  by  the  sputum  and  droplets  of  tuberculous 
patients. 

5.  The  habitations  of  consumptives  as  well  as  their  personal  effects, 
clothing,  etc.,  are  infected  and  liable  to  convey  the  disease  to  others. 

Space  will  not  permit  me  to  consider  in  detail  the  measures  for 
the  prevention  of  this  disease,  but  I  desire  to  emphasize  a  few  which 
may  be  resorted  to  in  the  control  of  the  sources  of  infection  and  the 
diminution  of  the  predisposing  causes : 

1.  Compulsory  notification  of  cases  to  the  health  authorities  as 
soon  as  the  disease  is  recognized.  This  is  of  vital  importance  for 
the  location  and  control  of  the  sources  of  infection,  and  for  the 
protection  of  the  family  and  others.  It  has  been  urged  that  the 
depressing  effect  of  such  information  would  be  too  great  for  the 
patient,  but  this  will  surely  be  counterbalanced  when  we  inform  him 
that  it  is  a  curable  and  preventable  disease,  and  that  his  chances 
for  recovery  are  especially  favorable  if  he  does  not  reinfect  himself. 

The  health  authorities,  apart  from  distributing  proper  printed 
directions  for  the  use  of  the  family  and  the  patient,  as  regard  the 
care,  disinfection  of  sputum  and  avoidance  of  droplet  infection, 
should  also  resort  to  disinfection  of  the  home  and  personal  effects, 
especially  upon  the  death  of  the  patient  or  vacation  of  the  premises. 
It  is  a  good  plan  to  receive  the  expectoration  into  paper  spitting 
cups,  paper  napkins,  or  moist  saw  dust,  which  should  be  burned. 
Cuspidors  should  contain  a  carbolic  acid  solution   (6  ounces  to  a 


170  BEPOBTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

gallon  of  water).  The  patient,  when  outdoors,  should  use  pocket 
spitting  flasks,  and  during  coughing  or  sneezing  hold  a  handkerchief 
over  mouth  or  nose.  Under  no  circumstances  should  patients  spit 
into  spaces  where  the  expectoration  may  be  dried,  and  as  pulverized 
dust,  gain  access  to  the  air.  The  same  directions  about  disinfection 
apply  to  cases  suffering  from  pneumonia,  influenza,  and  diphtheria. 
The  public  should  not  cultivate  an  exaggerated  fear  of  such  cases, 
but  has  a  right  to  insist  upon  clean  and  decent  precautions. 

2.  The  enactment  and  enforcement  of  laws  against  promiscuous 
expectoration  and  coughing  into  the  faces  of  persons  where  the 
sputum  is  liable  to  infect,  and  provisions  for  suitable  spittoons  and 
their  proper  disinfection  in  all  public  places  are  called  for.  The 
streets  should  be  sprinkled  and  swept  at  night  so  as  to  reduce  the 
inhalation  of  germ-laden  dust  to  a  minimum. 

3.  The  supervision  of  the  sanitary  condition  of  hotels,  theaters, 
churches,  schools,  ambulance  service,  sleeping  cars,  etc.,  should  like- 
wise be  under  the  control  of  the  health  department,  and  house- 
cleaning  should  be  accomplished  as  far  as  practicable  by  the  vacuum 
system. 

4.  Marriage  with  a  tuberculous  person  should  not  only  be  dis- 
couraged, but  absolutely  prohibited  by  law.  A  tuberculous  mother 
should  not  nurse  her  infant,  and  in  the  selection  of  a  wet  nurse  a 
certificate  of  health  should  be  demanded. 

5.  Isolation  of  tuberculous  patients  should  be  insisted  upon  in  hos- 
pitals, asylums,  and  public  institutions.  In  private  life  the  patient 
should  occupy  at  least  a  separate  bed,  use  separate  eating  and  drink- 
ing utensils,  and  neither  receive  nor  give  kisses. 

6.  Government  inspection  of  dairies  and  of  dairy  and  meat  prod- 
ucts, and  the  extermination  of  bovine  tuberculosis,  are  called  for. 
Until  this  is  accomplished  or  as  an  additional  precaution,  milk  should 
be  heated  to  150°  for  ten  minutes,  cooled  quickly  and  kept  cold,  and 
all  meats  should  be  well  cooked. 

Having  considered  the  sources  of  infection  and  the  indications  for 
their  control,  it  is  well  to  refer  to  what  may  be  done  towards  dimin- 
ishing the  predisposing  causes  to  consumption.  Many  of  these  ques- 
tions have  been  considered  under  personal  hygiene,  habitations,  ven- 
tilation, food,  alcohol,  tobacco,  clothing,  bathing,  etc.,  and  it  remains 
to  sum  up  the  duties  of  the  state  in  this  direction. 

Reference  has  already  been  made  to  the  good  effects  of  sewers  in 
preventing  air  pollution,  and  in  the  removal  of  dampness  by  drain- 
age. When  we  recall  the  influence  of  sewers  upon  the  prevalence 
of  the  disease,  and  remember  that  only  about  30  per  cent  of  the  popu- 
lation in  the  United  States  live  in  sewered  towns,  and  about  41  per 
cent  live  in  towns  having  public  water  supplies,  we  see  at  once  the 
necessity  that  a  system  of  public  sewerage  should  go  hand  in  hand 
with  the  public  water  supply.  The  neglect  on  the  part  of  the  State 
not  only  mcreases  the  dampness  of  the  soil,  but  compels  recourse  to 
the  various  makeshifts  for  the  collection  and  removal  of  excreta, 
and  leads  to  pollution  of  the  air,  soil,  and  water. 

INSANITARY   DWELLINGS. 

The  influence  of  insanitary  dwellings  on  the  prevalence  of  tuber- 
culosis has  already  been  emphasized.     In  addition  to  what  has  been 


KEPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  171 

said  on  page  104,**  it  should  be  remembered  that  the  tubercle  bacillus 
clinging  to  floors  and  walls  in  carelessly  expectorated  sputum  or 
droplets  would  be  destroyed  by  a  few  hours  of  sunlight,  but  finds  in 
damp  and  gloomy  rooms  a  suitable  environment  for  its  vitality  and 
growth;  and  the  other  insanitary  factors,  alluded  to  vastly  increase 
the  susceptibility  to  the  disease.  For  all  these  reasons  I  consider  the 
condemnation  of  houses  unfit  for  human  habitation  and  substitution 
of  sanitary  homes  only  second  in  importance  to  the  destruction  of  the 
germs. 

The  State  may  not  be  in  position  to  provide  sanitary  houses,  but  it 
can  at  least  regulate  and  supervise  the  construction  of  all  new  houses 
with  reference  to  the  exclusion  of  dampness,  sanitary  plumbing, 
amount  of  air  space,  light,  heating,  and  ventilation  of  dwellings, 
and  clearly  define  what  constitutes  an  insanitary  tenement,  offered 
for  rent,  and  provide  a  suitable  penalty.  The  State  should  also 
interdict  the  erection  of  tall  buildings,  and  of  all  buildings  covering 
over  66  per  cent  of  the  lot,  since  they  shut  out  light  and  air,  thus 
destroying  the  very  object  for  which  broad  streets  and  avenues  were 
created,  and  bringing  us  back  to  the  insanitary  era  of  the  medieval 
towns  with  their  narrow  and  winding  streets. 

PHYSICAL    CULTURE,    PUBLIC   PLAYGROUNDS,    AND   BATHS. 

The  State  should  pay  attention  to  the  physical  development  of  our 
youth,  and  this  is  best  accomplished  by  proper  training,  preferably  in 
the  open  air,  in  connection  with  the  public  schools  and  playgrounds. 
The  children  of  consumptives  require  special  attention  because  of  the 
transmission  of  vulnerable  anatomical  elements  which  render  them 
peculiarly  liable  to  the  disease ;  this  predisposition  may  certainly  be 
overcome,  in  addition  to  proper  food,  by  pure  air,  methodical  gym- 
nastics, and  systematic  hardening  of  the  skin  secured  by  bathing,  and 
no  school  should  be  without  these  hygienic  advantages.  If  it  be 
found  that  school  children  are  starving  for  want  of  food  it  is  clearly 
our  duty  to  make  suitable  provisions  to  prevent  permanent  depend- 
ency. No  effort  should  be  spared  to  increase  the  resisting  power  of 
the  individual.  Indeed,  we  are  altogether  too  apt  to  underrate  the 
question  of  soil  or  predisposing  factors  in  our  crusade  against  the 
disease. 

There  is  abundant  statistical  material  to  indicate  the  influence  of 
dust-producing  occupations  as  a  predisposing  factor  to  tuberculosis 
and  other  pulmonary  diseases,  and  it  is  clearly  the  duty  of  the  State 
to  formulate  efficient  laws  in  regard  to  factory  sanitation  and  the 
occupations  in  general  which  are  injurious  to  health. 

It  is  certainly  the  duty  of  the  State  to  see  that  every  patient  who 
has  no  home,  or  whose  environment  offers  less  favorable  conditions 
for  his  recovery,  is  provided  with  proper  care  and  shelter.  It  may  be 
truly  said  that  hospital  treatment  of  consumptives  offers  the  best 
chances  for  recovery  and  the  ultimate  extermination  of  the  disease, 
and  the  State,  until  a  comprehensive  system  of  industrial  insurance 
has  been  adopted,  must  shoulder  the  responsibility  in  the  case  of 
patients  unable  to  bear  the  financial  burdens.  Every  city  of  any  size 
should  provide  facilities  for  the  isolation  and  proper  treatment  of 

•Kober's  Industrial  Hygiene. 


172  REPORTS   OF   THE   PRESIDENT'S   HOMES   COMMISSION. 

the  patients,  supplemented  by  general  state  sanatoria.  Since  the 
identification  of  the  disease  is  the  first  and  most  important  step  in  its 
treatment  and  prevention,  the  establishment  of  dispensaries  for  the 
recognition  of  incipient  cases  among  the  dependent  classes  seems  ur- 
gently called  for.  Such  dispensaries  should  become  the  feeders  for 
municipal  and  state  sanatoria,  and  when  properly  conducted,  with 
special  reference  to  social  service,  will  be  a  most  important  factor  in 
the  combat  against  tuberculosis.  In  all  such  cases  it  is  desirable  to 
sift  charity  from  abuse ;  and  it  devolves  upon  the  State  to  determine 
the  financial  condition  of  the  applicant  and  also  prevent  destitution 
of  the  family  while  the  breadwinner  is  incapacitated  for  work.  It 
is  also  the  duty  of  the  State  to  suppress  quackery,  for  no  class 
falls  more  readily  a  prey  to  unscrupulous  mountebanks  than  our 
consumptives. 

The  Federal  Government  is  already  performing  an  important  duty 
by  exercising  a  watchful  care  over  the  subject  of  tuberculosis  among 
animals.  The  preventive  measures  urged  by  the  Bureau  of  Animal 
Industry  are  of  far-reaching  significance,  although  primarily  in- 
tended to  protect  the  pocketbooks  of  our  farmers  and  stock  raisers. 
Large  sums  are  annually,  and  very  properly,  expended  to  quarantine 
our  seaports  against  cholera,  yellow  fever,  and  smallpox,  because 
these  diseases,  if  permitted  to  gain  a  foothold,  occur  in  epidemics,  are 
rapidly  fatal,  and  hence  strike  terror  into  a  community.  It  is  to  be 
hoped  that  similar  opportunities  will  be  afforded  the  public-health 
service  to  cope  with  tuberculosis,  which  claims  more  victims  than  all 
these  diseases  combined. 

In  the  actual  care  and  treatment  we  also  have  a  right  to  expect  a 
more  active  participation  on  the  part  of  the  Federal  Government.  It 
is  a  notorious  fact  that  thousands  of  helpless  cases  of  consumption 
are  annually  dumped  upon  our  States  and  Territories  which  have 
become  famed  as  health  resorts;  and  the  hospitals,  sanatoria,  and 
almshouses  of  the  Carolinas,  California,  Colorado,  Arizona,  and  New 
Mexico  are  filled  with  indigent  dying  consumptives. 

It  is  claimed  by  Mr.  Frank  D.  Witherbee,  in  "  Charities,"  Novem- 
ber 6,  1904,  that  in  Phoenix,  Ariz.,  public  and  private  charity  is 
taxed  to  the  uttermost,  and  that  three-quarters  of  the  money  ex- 
pended on  the  inmates  of  the  almshouses  goes  to  alien  consumptives. 
It  is  cruel  and  worse  than  useless  to  send  a  consumptive  away  from 
home  without  sufficient  means  to  secure  the  ordinary  comforts  and 
advantages  of  climatic  treatment,  and  the  Federal  Government  should 
not  tolerate  it.  But  until  this  is  prevented,  the  Public  Health  and 
Marine-Hospital  Service  should  be  authorized  to  study  the  problem, 
which  studies  may  form  the  basis  for  a  more  permanent  and  en- 
lightened amelioration  of  the  sufferings  of  this  unfortunate  class 
of  victims. 

It  is  ver}^  evident  that  the  great  problem  which  confronts  most  of 
our  sanatoria  to-day  is.  What  shall  be  done  with  the  class  of  indigent 
patients  whose  disease  has  been  arrested,  but  who  need  suitable  em- 
ployment and  surroundings  for  their  permanent  recovery?  While  it 
IS  hoped  that  the  opportunities  of  a  cooperative  system  will  broaden 
out  in  time  in  connection  with  the  State  sanatoria,  it  can  not  be 
denied  that  certain  sections  in  the  Far  West  offer  suitable  advantages 
for  a  permanent  cure,  and  the  question  arises  whether  the  Federal 


BEPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  173 

Government  would  not  be  justified  in  engaging  in  extensive  live- 
stock raising  and  employ  young  men  of  this  class  to  do  the  work? 
The  Government  needs  horses  and  mules,  beef  and  mutton,  butter 
and  dairy  products  for  the  public  service.  It  has  many  valuable 
reservations,  susceptible  of  cultivation  with  or  without  reclamation, 
and  there  is  no  good  reason  why  such  government  farms  should  not 
prove  self-supporting. 

The  results  of  the  government  sanatoria  for  consumptives  at  Fort 
Bayard,  Fort  Stanton,  and  Fort  Lyons  have  been  so  gratifying  that 
substantial  and  permanent  results  may  be  hoped  for  by  an  expansion 
of  the  system  to  at  least  the  civilian  employees  of  the  Government, 
along  the  lines  indicated,  or  by  the  establishment  of  colonies  for 
arrested  cases. 

PNEUMONIA. 

Pneumonia  ranks  next  in  frequency  to  consumption  as  a  cause  of 
death.  During  the  census  years  of  1900  there  were  105,971  deaths 
from  pneumonia  in  the  United  States. 

The  records  of  the  health  department  show  that  during  the  past 
twelve  years  there  were  5,947  deaths  from  this  disease  in  the  District 
of  Columbia,  2,632  white  and  3,315  colored. 

The  undue  prevalence  of  pneumonia  and  tuberculous  diseases  of 
the  respiratory  system  is  general.  The  colored  population  shows  a 
peculiar  susceptibility,  which  is,  in  all  probability,  caused  by  environ- 
ment and  sociological  factors  rather  than  by  racial  differences.  At 
all  events,  an  attempt  will  be  made,  on  page  210,  to  account  for  the 
undue  mortality  among  our  colored  population. 

Pneumonia,  like  tuberculosis,  is  an  infectious  disease,  and  is  caused 
by  a  microbe,  first  discovered  by  Gen.  George  M.  Sternberg  in  1880, 
and  subsequently  demonstrated  to  be  the  essential  factor  in  the 
causation  of  the  disease.  This  germ,  known  as  a  micrococcus,  is 
found  in  a  considerable  number  in  the  mouth  and  saliva  of  perfectly 
healthy  subjects,  and  in  very  great  numbers  in  the  phlegm  which 
fills  the  air  cells  of  the  affected  part  of  the  lung,  and  is  coughed  up 
during  the  disease  in  the  form  of  rusty  sputum.  The  rusty  appear- 
ance is  due  to  the  presence  of  blood  corpuscles  issuing  from  highly 
inflamed  lung  tissue.  The  danger  in  pneumonia  depends  upon  the 
extent  of  lung  tissue  involved,  the  amount  of  toxins  generated  and 
absorbed,  the  condition  of  the  heart  and  kidneys,  and  the  general 
power  of  resistance  of  the  patient. 

In  the  causation  of  the  disease  we  are  evidently  dealing  with 
several  factors,  viz,  the  presence  of  the  micrococcus,  individual  pre- 
disposition, and  an  exciting  cause.  Since  the  germ  has  been  found  in 
the  mouths  of  perfectl}^  healthy  persons,  and  was,  in  fact,  discovered 
by  General  Sternberg  in  his  own  saliva,  we  may  conclude  that  the 
invasion  of  the  microbe  alone  is  not  sufficient  to  produce  the  disease. 
If,  therefore,  an  attack  of  pneumonia  results,  the  patient  must  have 
furnished  a  suitable  soil  for  the  rapid  multiplication  of  the  germs, 
and  the  structural  changes  which  are  brought  about  by  their  agency. 
As  in  tuberculosis,  so  in  this  disease  debilitating  factors  and  depress- 
ing influences,  such-  as  malnutrition,  alcoholism,  and  insanitary  sur- 
roundings, are  important  predisposing  causes.  But,  in  addition  to 
all  this,  there  must  be  an  exciting  cause.    A  caref  id  study  of  the  soa- 


174  BBPORTS  OF  THE  PBESIDENT's  HOMES  COMMISSION. 

sonal  prevalence  shows  that  pneumonia,  like  tuberculosis,  bronchitis, 
and  congestion  of  the  lungs,  is  very  much  influenced  by  temperature, 
humidity,  and  prevailing  winds.  The  following  chart  of  the  health 
department  shows  deaths  from  pneumonia  during  1906,  arranged  by 
months,  compared  with  the  average  monthly  deaths  for  the  past  ten 
years.  This  chart  shows  that  the  disease  is  especially  prevalent  dur- 
ing the  colder  months  of  the  year,  and  reaches  a  minimum  in  June, 
July,  August,  and  Septen.ber.  It  is  well  known  that  cold,  and  espe- 
cially damp  cold,  winds,  are  often  the  cause  of  catching  cold,  prob- 
ably because  they  abstract  bodily  heat  in  proportion  to  their  velocity, 
and  if  this  takes  place  to  an  unusual  degree,  or  with  great  abruptness, 
the  capillaries  of  the  skin  contract,  the  blood  is  driven  into  the  in- 
ternal organs,  and  congestion  results,  usually  in  the  weakest  spot. 
As  an  additional  effect  of  sudden  changes  in  temperature,  we  have 
the  suppression  of  the  cutaneous  function  and  consequent  retention 
of  effete  matter  in  the  blood.  We  can  readily  appreciate  how  all 
this  may  be  aggravated  by  the  habitual  presence  of  alcohol  in  the 
blood  current,  which  diminishes  oxidation  of  the  waste  products,  and 
also  by  overcrowding,  because  the  effect  of  deficient  air  supply  is  not 
only  to  reduce  the  quantity  of  carbonic  acid  by  expiration,  but  also 
to  diminish  the  normal  oxidation  of  effete  matter.  In  any  event,  the 
conditions  referred  to  favor  the  accumulation  of  effete  matter,  render 
the  blood  current  sufficiently  impure  to  lose  its  germicidal  properties, 
and  thus  constitute  a  suitable  fluid  for  the  rapid  multiplication  of 
the  pneumococcus  invader.  It  is  also  evident  that  other  depressing 
influences,  such  as  previous  illness,  especially  an  attack  of  measles  or 
of  influenza,  vastly  increase  the  vulnerability  of  the  tissues  and 
chances  of  infection. 

This  disease  is  doubtless  communicable  from  sick  to  well  persons,  as 
shown  by  the  occurrence  of  epidemics  in  prisons,  institutions,  etc.; 
indeed,  its  infectiveness  is  no  longer  a  matter  of  doubt,  and  calls  for 
prompt  disinfection  of  the  sputum  and  avoidance  of  close  contact,  in 
the  manner  already  described  in  the  care  of  tuberculous  patients. 

While  precautionary  measures  for  the  destruction  of  the  germs  are 
of  great  importance  in  stamping  out  the  sources  of  infection,  our  aim 
must  also  be  directed  toward  the  correction  of  predisposing  and  ex- 
citing causes.  This  we  can  do  by  clothing  adapted  to  climate  and  sea- 
sons, proper  housing  conditions  as  regards  heating  and  ventilation. 
proper  food,  and  temperate  habits.  The  disease,  unfortunately,  is 
mcreasing  in  this  country,  and  the  increase  is  doubtless  influenced 
by  the  increased  consumption  of  alcohol.  We  have  already  empha- 
sized the  fact  that  pneumonia  is  vastly  more  fatal  among  the  topers. 

We  may  also  lessen  the  harmful  effects  of  abrupt  changes  in  tem- 
perature by  systematic  hardening  of  the  skin,  remembering  always 
that  a  normal  function  of  the  skin  depends  largely  upon  .cleanliness, 
and  a  proper  tone  of  the  cutaneous  vessels  and  nerves,  secured  by 
bathing. 

INFI.UENZA    (la  GRIPPE )  . 

Influenza  or  epidemic  catarrh  is  also  an  infectious  disease,  caused  by 
a  very  small  bacillus,  discovered  by  Pfeiffer  in  1892.  This  organism 
is  constantly  found  in  the  bronchial  and  nasal  secretions  of  the  af- 
fected persons,  and,  as  in  tuberculosis  and  diphtheria,  is  largely  dis- 


MONTHLY  DEATHS  FROM   PNEUMONIA  DURING  1906,  COMPARED  WITH  AVERAGE  MONTHLY 
DEATHS  FOR  PAST  TEN  YEARS. 


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^Auerage  deaths  from  Pneumonia,  by  months,  for  10  years. 

Reproduced  from  the  Report  of  the  Health  Officer,  District  of  Columbia,  1907 


BEPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  175 

seminated  by  close  contact  with  the  sick.  The  disease  often  assumes 
pandemic  proportions,  because  all  ages  are  susceptible  to  infection, 
and  no  precautions  are  taken  to  guard  against  its  contagious  nature. 
As  early  as  1173  the  disease  is  reported  to  have  appeared  in  different 
parts  of  Germany,  Italy,  and  England,  and  since  then  over  60  epi- 
demics have  been  recorded,  of  which  15  were  very  extensive.  The 
disease  in  the  United  States  was  first  recognized  in  New  England  in 
1627,  and  a  number  of  epidemics,  notably  those  of  1807,  1815,  1824, 
1847-^8,  1851,  1857-58,  1874-75  have  been  recorded.  The  most  ex- 
tensive epidemic  occurred  in  1892  to  1897,  and  during  the  census  year 
1900  there  were  no  less  than  16,645  deaths  from  the  disease  in  this 
country.  During  the  past  twelve  years  808  deaths  were  reported  in 
the  District  of  Columbia.  It  is  by  no  means  a  trivial  affection,  as  it 
carries  off  a  number  of  persons,  chiefly  from  pneumonic  complica- 
tions, and  wrecks  the  health  of  many  more  by  affections  of  the  nerv- 
ous system,  heart,  kidneys,  eyes,  and  ears.  In  the  prevention  of  the 
disease  the  same  general  rules  which  have  been  urged  in  tuberculosis 
and  pneumonia  are  clearly  indicated. 

TYPHOID    FEVER. 

Typhoid  fever  carries  off  annually  over  35,000  victims  in  the  United 
States.  According  to  the  records  of  the  health  department,  there 
were  during  the  ten  years  ended  December  31,  1906,  1,693  deaths  (968 
white  and  725  colored)  from  this  disease  in  the  city  of  Washington. 
Based  upon  an  estimated  mortality  of  10  per  cent,  it  is  within  reason 
to  assume  that  there  were  not  less  than  16,930  cases  during  the  same 
period.  If  we  calculate  the  average  cost  for  care,  treatment,  and  loss 
of  work  to  be  $300,  and  the  average  value  of  a  human  life  $5,000,  we 
have  a  total  loss  in  the  vital  assets  of  this  community  of  $13,544,000 
from  one  of  the  so-called  preventable  diseases. 

Typhoid  fever  is  essentially  a  filth  disease,  caused  by  a  specific 
bacillus,  which  is  constantly  found  in  the  intestinal  discharges,  and 
almost  always  in  the  blood  and  urine  of  typhoid  fever  patients.  The 
invasion  of  the  microbe  most  likely  takes  place  through  the  ali- 
mentary tract,  as  evidenced  by  the  location  of  the  disease  in  the  intes- 
tines, and  the  frequent  dissemination  of  the  germs  through  the  water 
and  milk  supply.  The  possibility  of  transmission  through  the  air 
should  not  be  excluded,  for,  as  in  tuberculosis,  so  in  this  disease  the 
infectious  material  may  have  become  dried  and  pulverized,  and  with 
particles  of  dust  may  gain  access  to  the  food  or  the  mouth,  there  to 
be  swallowed  or  inhaled. 

The  principal  source  of  transmission,  however,  is  through  the  water 
supply,  infected  milk,  food,  and  infected  hands.  In  all  such  in- 
stances the  virus  proceeds  primarily  from  the  stools  and  urine  of 
typhoid  patients,  and  gains  access  through  sewers,  or  otherwise,  to 
the  water  supply,  or  contaminates  vegetables  and  fruit  which  are 
eaten  raw,  through  the  medium  of  night  soil  or  washing  them  with 
infected  water.  Milk  and  food  may  be  contaminated  by  washing  the 
utensils  with  infected  water  or  by  handling  it  with  unclean  or  in- 
fected fingers.  The  writer,  in  his  investigation  of  the  typhoid-fever 
situation  in  1895,  also  pointed  out  how  flies  may  carry  the  germs  on 
their  feet,  from  typhoid  stools  and  infected  sources,  to  the  food  and 


176  RKPOBTS  OP  THE  PBBSIDENt's  HOMES  COMMISSION. 

milk  supply.  There  is  special  danger  from  infection  of  the  fingers  in 
handling  or  washing  soiled  patients,  or  their  clothing,  bedding,  and 
utensils,  as  the  germs  from  the  soiled  parts  may  cling  to  the  fingers 
and  be  conveyed  to  the  mouth  during  eating,  or  infect  the  food  and 
milk  of  others  in  handling  it,  unless  the  hands  have  been  thoroughly 
washed  after  every  unclean  act.  Moreover,  it  has  been  shown  within 
the  last  ten  years  that  some  persons  after  recovering  from  typhoid 
fever  may  continue  to  carry  the  germs  and  spread  them  through  the 
urine  and  feces,  although  the  persons  themselves  apparently  enjoy 
good  health.  From  the  statistics  of  Lentz,  Klinger,  and  V.  Drigal- 
ski,  Goldberger  estimates  that  about  3  per  cent  of  typhoid- fever 
patients  become  "  chronic  bacillus  carriers,"  and  thus  constitute  an 
important  source  of  infection,  chiefly  in  handling  milk  and  food. 
Those  who  are  familiar  with  the  average  dairy  employee  or  cooks  will 
have  no  difficulty  in  surmising  how  the  fingers  may  become  infected 
by  careless  toilet  habits.  Indeed,  it  is  very  evident  that  the  Mosaic 
law  of  ablution  of  the  hands  after  every  unclean  act  can  not  be  too 
strongly  urged  in  the  light  of  our  knowledge  concerning  the  trans- 
mission of  disease  germs. 

Notwithstanding  the  different  modes  of  dissemination  of  the  germs, 
it  should  be  remembered  that  typhoid  fever  is  a  typical  water-borne 
disease.  The  infection  of  a  water  supply  is  either  direct  or  indirect; 
the  former  includes  all  instances  where  the  water  is  contaminated  by 
specifically  infected  sewage  emptied  directly  into  the  river  or  lake, 
or  by  excreta  deposited  along  the  banks,  which  sooner  or  later  are 
washed  into  the  water  supply.  By  indirect  infection  we  understand 
those  instances  in  which  the  excreta,  or  wash  waters,  have  been  de- 
posited in  or  upon  the  soil,  and  by  percolation  finally  reach  wells, 
springs,  or  other  bodies  of  water. 

That  the  excreta  from  a  single  typhoid  patient  have  infected  the 
water  supply  of  a  whole  community  has  been  shown  in  connection 
with  the  epidemic  at  Cumberland  in  1889,  the  history  of  which  shows 
that  there  were  no  cases  of  typhoid  fever  in  that  town  until  the  dis- 
charges from  a  young  man,  who  returned  from  Ohio  in  December, 
quite  sick,  found  their  way  into  the  public  water  supply.  This  case 
died  December  20.  The  next  case  appeared  January  10,  1890,  and 
within  a  short  time  485  cases  developed  in  a  population  of  1,200. 
Every  case  but  one  was  traced  to  polluted  river  water.  The  accom- 
panying chart  shows  that  the  epidemic  resulted  in  the  highest  typhoid 
mortality  rate  ever  reached  in  this  city,  viz,  104  deaths  in  every 
100,000  of  the  population. 

The  typhoid  fever  epidemic  at  Plymouth,  Pa.,  which  affected  over 
1,100  persons,  and  began  April  9,  1885,  was  traced  to  a  case  who  con- 
tracted the  disease  elsewhere,  returned  to  his  home  in  January,  1885, 
and  was  for  many  weeks  quite  ill.  The  dejecta  from  this  case  was 
thrown  along  the  sloping  banks  of  a  mountain  stream,  where  they 
remained  innocuous  upon  the  snow  and  frozen  ground  until  some 
time  between  March  25  and  April  1,  when  thaws  set  in.  Under  the 
influence  of  this  thaw  they  were  washed  into  the  mountain  stream 
and  carried  into  the  reservoir  which  supplied  the  town  with  water. 
There  is  every  reason  to  believe  that  the  typhoid  fever  germs  were 
distributed  in  the  water  between  March  28  and  April  4  or  5.  The 
first  case  was  reported  April  9,    During  the  week  beginning  April  12 


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MEAN  DEATH  RATES  FROM  TYPHOID  FEVER.  T902  TO  1906,  IN  66  AMERICAN  CITIES  AND  7  FOREIGN  CITIES.     GROUPED, 

AFTER  FUERTES.  ACCORDING  TO  THE  QUALITY  OF  THEIR  DRINKING  WATER.     THE 

RATES  FOR  FOREIGN  CITIES  ARE    TAKEN  FROM  JAMES  H.  FUERTES. 


BEPOBTS  OF  THE  PBESIDENT's  HOMES  COMMISSION.  177 

from  50  to  100  cases  appeared  daily,  and  on  one  day  it  is  said  that 
200  new  cases  were  reported. 

Such  instances  might  be  multiplied  by  the  hundreds ;  we  have  sim- 
ply to  recall  the  epidemic  at. Ithaca,  N.  Y.,  during  the  months  of 
January,  February,  and  March,  1903,  affecting  1,350  persons  in  a 
population  of  13,000,  with  78  deaths,  among  them  128  students  at 
Cornell  University,  with  26  deaths.  The  epidemic  at  Butler,  Pa.,  in 
the  same  year,  affecting  1,348  persons  with  111  deaths  in  a  popula- 
tion of  18,000;  the  epidemic  at  Columbus,  Ohio,  in  1904,  with  1,640 
cases  and  166  deaths  in  a  population  of  140,000 ;  and  the  more  recent 
epidemic  of  Scranton,  in  1906-T,  with  970  cases  and  77  deaths,  are 
other  shocking  examples  of  water-borne  typhoid. 

INFLUENCE    OF    WATER    SUPPLIES    UPON    TYPHOID    FEVEB. 

Sanitarians  are  so  convinced  that  a  pure  water  supply  is  incom- 
patible with  a  high  typhoid  fever  rate  that  they  unhesitatingly 
declare,  "  Show  me  a  city's  statistics  of  the  disease  and  I  will  tell 
you  the  character  of  its  water  supply."  The  writer,  in  a  paper  on 
"Conservation  of  life  and  health  by  improved  water  supply,"  pre- 
sented a  number  of  diagrams  showing  the  typhoid  fever  rate  in  a 
number  of  cities,  classified  according  to  their  water  supply,  of  which 
plate  7  is  here  reproduced. 

This  diagram  also  conclusively  shows  that  the  European  cities 
which  do  not  only  prevent  pollution  of  rivers,  but  also  filter  their 
water,  enjoy  the  lowest  typhoid  fever  rates.  In  the  same  paper  the 
writer  has  shown  that  in  seven  American  cities  the  reduction  in  ty- 
phoid fever,  after  the  introduction  of  pure  water,  amounted  to  70.5 
per  cent,  and  that  during  the  past  twenty-five  years  the  death  rate 
from  typhoid  fever  in  14  countries  and  cities,  tabulated  by  him,  has 
been  reduced  54.3  per  cent.  The  Bulletin  for  the  month  of  April, 
1908,  of  the  New  York  State  department  of  health  shows  that  the 
death  rate  from  typhoid  fever  in  10  cities  of  that  State  has  been 
reduced  53.4  per  cent  by  an  improved  water  supply. 

CAUSES   OF  TYPHOID   FEVEB. 

The  writer  has  heretofore  held  that  about  50  per  cent  of  the  cases 
are  water  borne  (well,  river,  commercial,  and  ice),  and  has  taught 
for  years  that  wells  in  this  city,  on  account  of  soil  pollution,  should 
not  be  tolerated,  and  that  the  only  way  to  render  a  suspicious  supply 
safe  for  drinking  purposes  was  to  boil  the  water.  The  danger  from 
Potomac  water  since  filtration,  has  been  practically  eliminated,  but 
ice  should  not  be  mixed  with  it  as  it  may  be  as  impure  as  the  water 
from  which  it  is  derived.  Moreover,  iced  drinks  and  foods  are  also 
objectionable  on  account  of  the  injury  to  the  digestive  functions, 
especially  in  the  summer  months,  unless  sipped  very  slowly,  and, 
upon  general  principles,  ice  cream  should  be  made  with  sterilized 
cream. 

In  the  writer's  report  on  typhoid  fever  for  1895,  he  urged  as  a 
preventive  measure  the  boiling  of  milk,  and  the  systematic  inspection 
of  dairies.  This,  together  with  the  fact  that  he  has  tabulated  195 
of  so-called  milk-borne  typhoid  epidemics,  clearly  indicates  that  in 
his  judgment  milk  is  to  a  certain  extent  responsible  for  the  dissemi- 
S.  Doc.  644,  60-2 13 


178  BEPORTS   OF   THE  PRESIDENT'S   HOMES   COMMISSION. 

nation  of  the  disease,  probably  in  about  15  per  cent  of  the  cases.  In 
148  of  the  195  epidemics  analyzed  by  him  there  is  evidence  of  the 
disease  having  prevailed  at  the  farm  or  dairy.  In  67  instances  it  is 
probable  that  the  infection  reached  the  milk  by  soakage  of  the  germs 
into  the  well  water  with  which  the  utensils  were  washed,  and  in  16 
instances  the  intentional  dilution  with  polluted  water  is  a  matter  of 
evidence.  In  7  instances  the  infection  is  attributed  to  the  cows  wad- 
ing in  sew  age- polluted  water  and  meadows,  and  it  is  quite  conceiv- 
able that  the  germs  clinging  to  the  udder  and  teats  found  their  w^ay 
into  the  milk.  In  4  instances  the  infection  was  spread  through 
cream  prepared  in  infected  premises.  In  7  instances  through  cream- 
eries. In  1  instance  the  milk  tins  were  washed  with  the  same  cloth 
used  among  the  fever  patients.  In  other  instances  the  germs  were 
probably  carried  into  the  milk  by  flies  passing  from  the  infected 
excreta.  In  24  instances  the  people  handling  the  milk  also  acted  as 
nurses.  In  10  instances  patients  while  suffering  from  mild  attacks, 
or  during  the  first  ten  days  of  their  illness,  continued  at  work.  From 
what  has  been  said  of  the  danger  of  soiled  hands,  we  may  assume 
that  the  germs  in  all  such  instances  may  be  conveyed  in  the  manner 
already  explained. 

In  like  manner  a  "  chronic  bacillus  carrier  "  may  convey  the  germs 
by  soiled  fingers  into  the  milk.  This  mode  of  infection  was  strongly 
suspected  ever  since  Doctor  Soper,  of  New  York,  traced  a  number 
of  household  epidemics  to  an  infected  cook,*^  and  also  by  a  very  in- 
teresting instance  reported  by  Dr.  Henry  Albert,  occurring  in  the 
fall  of  1907,  at  Cedar  Falls,  Iowa.  The  possibility  of  spreading  the 
disease  by  such  a  carrier  has  been  materially  strengthened  by  a  study 
of  a  milk-borne  typhoid  epidemic  in  this  city  in  October,  1908. 
Surgeon-General  Wyman's  report  says: 

Twenty-six  cases  of  typhoid  in  Georgetown,  occurring  between  October  8  and 
15,  were  traced  througli  tlie  milk  to  ttie  dairy  farm.  On  close  inspection  of 
this  dairy  farm  no  case  of  typhoid  fever  for  years  could  be  found  to  have 
occurred  among  any  of  the  employees,  nor  was  any  other  source  of  infection 
discovered  until  after  a  systematic  examination  of  dejecta  of  all  the  em- 
ployees had  been  made  in  the  hygienic  laboratory. 

This  examination  developed  large  numbers  of  typhoid  bacilli  In  the  dejecta 
of  one  woman  who  had  had  typhoid  fever  eighteen  years  before,  and  was  one 
of  the  milkers  of  the  dairy.  Persons  thus  affected  are  known  to  the  medical 
profepfeion  as  typhoid  bacilli  carriers,  but  this  is  the  first  considerable  outbreak 
of  typhoid  in  the  United  States  traced  through  milk  to  such  a  carrier,  excepting 
the  case  reported  by  Dr.  Henry  Albert,  of  Iowa,  in  the  "  Hygienic  Laboratory 
Bulletin,"  on  "Milk  and  Its  Relation  to  the  Public  Health,"  published  last 
January. 

The  case  just  discovered  is  deemed  of  special  interest  to  health  officers  in 
their  endeavors  to  trace  the  source  of  typhoid  outbreaks  when  that  source 
seems  to  be  obscure.  At  least  2  per  cent  of  all  recovered  cases  of  typhoid 
fever  become  bacilli  carriers  for  a  longer  or  shorter  period,  even  while  enjoying 
good  health.  Ten  per  cent  of  the  cases  of  typhoid  fever  in  Washington  during 
the  past  three  years  have  been  definitely  traced  to  infected  milk. 

This  instance  is  of  extreme  interest  and  certainly  suggestive  of  dan- 
ger, but  scientific  critics  may  be  tempted  to  ask:  (1)  If  this  woman 
was  the  only  possible  source  of  infection,  why  did  she  not  infect  the 
consumers  of  the  milk  before?  unless,  indeed,  it  can  be  shown  that  she 
had  a  recent  reinfection;  (2)  were  the  typhoid  fever  germs  actually 
found  in  the  milk?   (3)   if  not,  why  was  there  no  effort  made  to 

<»"  Journal  American  Medical  Association,"  Vol.  XLVIII,  No.  24,  p.  2019. 


REPORTS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  179 

demonstrate  experimentally  that  this  woman  with  the  careless  toilet 
habits  could  infect  her  hands  and  through  it  the  milk?  and  (4)  have 
all  other  local  sources  of  infection  in  Georgetown  been  effectually 
eliminated  ? 

The  evidence  on  milk  infections  shows  how  important  it  is  for  us  to 
bring  our  milk  to  the  boiling  point  (scalding),  which  will  kill  the 
germs.  In  this  connection  it  is  interesting  to  note  that,  of  the  330 
milk  epidemics  (typhoid,  scarlet  fever,  and  diphtheria)  collected  by 
the  writer,  243  have  been  recorded  by  English  authors,  52  by  Ameri- 
can, 14  by  German,  11  by  Scandinavian,  and  5  each  by  French  and 
Australian  writers.  This  is  probably  due  to  the  fact  that  the  Eng- 
lish and  Americans  usually  consume  raw  milk,  while  on  the  Conti- 
nent milk  is  rarely  used  without  being  first  boiled. 

About  15  per  cent  of  all  typhoid  cases  are  brought  to  the  city  from 
summer  resorts  and  rural  districts,  and  about  20  per  cent  may  be 
spread  through  the  agency  of  flies,  personal  contact,  the  consumption 
of  raw  oysters  and  shell  fish  raised  in  sewage-polluted  waters,  or  the 
eating  of  strawberries,  radishes,  celery,  lettuce,  and  other  vegetables 
and  fruits  which  have  been  contaminated  with  infected  night  soil. 
Hence  the  importance  of  carefully  washing  all  uncooked  articles 
of  food. 

TYPHOID    FEVEB   IN    THE    EURAL    DISTRICTS. 

There  is  much  reason  for  assuming  that  the  undue  prevalence  of 
typhoid  in  rural  districts  is  a  fruitful  source  of  infection  to  the  urban 
population,  chiefly  through  the  milk  supply  and  summer  boarders. 

When  we  consider  the  fact  that  over  70  per  cent  of  our  population 
resides  in  rural  districts,  that  the  "  bone  and  sinew "  of  these  are 
engaged  in  agricultural  pursuits,  and  that  they  do  not  enjoy  the 
benefits  of  enforced  sanitation  by  local  health  boards,  we  see  at  once 
the  desirability  of  the  family  physician  extending  useful  suggestions 
on  healthful  building  sites  and  homes,  disposal  of  house  wastes,  the 
importance  of  a  pure  water  supply,  wholesome  and  properly  cooked 
food,  etc.  As  it  is  now,  the  diet  is  faulty,  especially  the  hot  biscuits 
and  greasy  fried  dishes,  while  wells  and  privies  are  often  dangerous 
neighbors,  favoring  the  spread  of  filth  diseases.  The  undue  prev- 
alence of  typhoid  fever  could  be  materially  checked  by  chemical  dis- 
infectants, or  by  adding  to  the  discharges  four  or  five  times  the 
quantity  of  boiling  water  kept  in  contact  for  at  least  ten  minutes. 
While  prompt  disinfection  of  the  excreta  is  of  vital  importance,  we 
should  also  make  an  effort  to  get  rid  of  the  flies  by  prompt  disposal 
of  the  horse  manure  in  which  they  breed,  the  abandonment  of  open 
privies  and  surface  pollution,  substitution  of  the  dry  earth  closet,  or 
other  rational  methods  for  the  collection  and  disposal  of  excreta, 
removal  of  garbage,  etc 

PREDISPOSING  CAUSES  TO  TYPHOID  FEVEB. 

The  writer,  in  his  investigation  of  500  cases  in  1895,  found  that  in 
a  large  number  of  cases,  especially  in  the  southwest  and  along  the 
eastern  branch  of  the  Potomac,  the  system  was  very  much  debilitated 
by  the  malarial  cachexia  prior  to  the  attack.  What  effect  the  James 
Creek  Canal,  the  backing  up  of  sewage  and  consequent  flooding  of 


180  REPORTS  OF  THE  PRESIDENT'S  HOMES  COMMISSION. 

uncemented  basements  and  cellars,  or  the  emanations  from  the  filth- 
reeking  shores  may  have  had,  as  a  contributory  factor,  it  is  difficult 
to  say.  We  know,  however,  that  marshes  breed  mosquitoes,  which 
are  the  carriers  of  malaria,  and  that,  apart  from  the  unwholesome 
emanations,  the  evaporation  of  water  also  increases  the  humidity  of 
the  air  and  thus  intensifies  the  effects  of  both  heat  and  cold,  all  of 
which  can  not  fail  to  lower  the  power  of  resistance  to  disease.  For 
these  reasons  his  fifth  recommendation,  submitted  in  1895,  referred 
to  sanitary  measures  looking  to  the  reclamation  of  the  stagnant  and 
polluted  marshes  and  the  prompt  disposal  of  sewage. 

In  this  connection  let  us  remember,  however,  that  while  the  Ana- 
costia  flats  are  productive  of  disease,  directly  and  indirectly,  similar 
effects,  differing  only  in  degree,  may  be  produced  by  filthy  homes, 
back  yards,  and  stagnant  pools  of  water  within  the  city  limits. 

The  same  report,  on  page  261,  says: 

In  addition  to  the  germ,  there  must  also  be  a  suitable  soil  for  its  proliferation 
in  the  system,  and  this  individual  predisposition  or  vulnerability,  which  renders 
the  body  more  liable  to  be  acted  upon  by  the  germs,  may  be  the  result  of 
debility,  faulty  nutrition,  fatigue^  excesses  of  all  kinds,  abrupt  changes  in 
temperature,  impure  air,  mental  depression,  unwholesome  food,  and  many  other 
factors  calculated  to  diminish  the  power  of  resistance  of  the  individual. 

The  factors  of  environment  and  other  predisposing  causes  jye 
plainly  revealed  by  the  imdue  fatality  in  the  colored  population.  The 
average  typhoid  death  rate  among  the  colored  during  the  past  ten 
years  was  76.4,  as  compared  with  47.4  for  the  whites. 

Many  of  the  factors  concerned  will  be  alluded  to  on  page  210,  and 
much  may  be  done  by  uplifting  influences  and  higher  standards  of 
living  toward  the  removal  of  the  predisposing  causes  of  typhoid  fever. 

WHY  IS  THEBE   MORE  TYPHOID  FEVEB  IN   WASHINGTON   THAN   IN  NORTHERN    CITIES? 

Now  that  we  have  a  pure-water  supply  this  very  pertinent  question 
has  been  asked,  and  among  the  answers  so  far  given  may  be  mentioned 
the  following: 

1.  Washington,  like  very  many  other  southern  cities,  has  a  very 
large  colored  population,  with  their  greater  susceptibility  to  disease. 
This,  however,  accounts  for  only  a  certain  percentage  of  the  excess, 
as  the  rate  for  the  white  population  is  also  abnormally  high. 

2.  It  is  a  well-known  fact  that  all  intestinal  diseases  are  especially 
prevalent  in  hot  climates  and  seasons.  This  is  probably  due  to  the 
fact  that  the  blood  is  kept  too  long  at  the  periphery  on  account  of 
excessive  perspiration,  and  the  stomach  and  other  internal  organs 
suffer  in  tone  and  nutrition  for  want  of  adequate  blood  supply,  and 
can  not  exert  their  normal  defensive  forces.**  So,  for  example, 
typhoid-fever  germs  would  be  digested,  like  many  other  vegetable 
cells,  as  long  as  the  digestive  functions  are  normal,  but  if  for  any 
reason  this  function  is  impaired  or  arrested,  this  defensive  force 
ceases,  and  the  way  for  infection  is  open.  Functional  derangements 
of  the  stomach,  together  with  the  debilitating  influences  of  heat, 
doubtless  play  an  important  role  in  increasing  the  general  suscepti- 
bility to  typhoid  fever  in  all  southern  climes. 

3.  Doctor  Woodward,  our  health  officer,  suggests  that  the  greater 
intensity  of  heat  in  the  South  leads  to  the  ingestion  of  larger  quan- 

«  See  page  80,  Kober's  Industrial  Hygiene, 


REPORTS    OF    THE  PRESIDEKT^S   UOMES   COMMISSION.  181 

titles  of  water  than  are  consumed  farther  north,  and,  therefore,  so  far 
as  water-borne  typhoid  fever  is  concerned,  to  increased  chances  of 
infection.  He  also  suggests  that  "  intensity  of  heat  and  the  long  dura- 
tion of  the  heated  season  probably  lead  to  a  more  rapid  and  more 
extensive  lowering  of  the  water  in  the  streams  and  wells  than  occurs 
in  cooler  regions,  and  thus  lead  to  a  greater  concentration  of  infec- 
tivity,  if  the  water  in  such  streams  and  wells  are  infected.  The 
temperature  of  the  water  in  such  streams  and  wells  may  be  better  suited 
to  the  lief  of  the  typhoid-fever  bacillus  than  is  the  temperature  of 
northern  waters.  Moreover,  owing  to  the  greater  duration  of  the 
summer  season,  the  fly  season  is  longer,  and  the  period  during  which 
the  diet  of  the  people  consists  largely  of  uncooked  articles  is  corre- 
spondingly extended.  The  chances  of  infection  are  therefore  cor- 
respondingly increased  in  so  far  as  relates  to  infection  through  foods. 
Still  it  would  be  but  poor  comfort  to  know  that  because  Washington 
is  a  southern  city  it  must  continue  forever  to  pay  its  death  toll  to  the 
typhoid-fever  Juggernaut;  the  problem  must  not  be  solved  in  that 
way.  But  the  problem  is  not  yet  solved,  nor  is  it  likely  ever  to  be 
solved  until  the  investigation  is  taken  up  along  broader  lines  than 
any  that  have  yet  been  adopted;  that  is,  until  the  investigation  into 
the  causes  of  the  undue  prevalence  of  typhoid  fever  in  this  District 
is  made  to  include  an  investigation  into  the  causes  of  the  prevalence 
of  typhoid  fever  elsewhere,  so  that  by  a  process  of  comparison  and 
exclusion  the  cause  for  the  excessive  typhoid  fever  rates  in  the  District 
of  Columbia  can  be  ascertained." 

PBEVENTION  OF  TYPHOID  FEVEE. 

The  writer,  in  his  report  on  typhoid  fever  in  1895,  referred  in  his 
concluding  recommendation  to  thorough  disinfection  of  the  excreta 
from  all  typhoid-fever  patients,  and  greater  care  on  the  part  of  those 
connected  with  the  sick.  We  have  known  for  over  twenty-five  years 
that  the  typhoid  germs  are  conveyed  chiefly  through  the  feces  and 
urine  of  infected  persons,  that  they  are  capable  of  reproduction 
within  and  without  the  body,  unless  killed  by  certain  physical  or 
chemical  agents.  We  have  already  mentioned  that  even  the  addi- 
tion of  four  or  five  times  the  volume  of  boiling  water  to  feces  or 
urine  will  effectually  destroy  the  vitality  of  the  germs.  If  chemical 
agents  are  used  the  method  must  be  thorough  and  exact.  The  at- 
tendant must  prepare  and  use  germicidal  solutions  of  standard 
strength,  and  unless  this  is  done  the  whole  process  is  a  snare  and 
delusion.  So,  for  example,  all  vessels  containing  stools  should  be 
filled  with  a  double  volume  of  a  solution  of  chloride  of  lime  (6 
ounces  to  the  gallon),  or  a  5  per  cent  solution  of  carbolic  acid,  6 
ounces  to  1  gallon  of  boiling  water,  or  a  corrosive  sublimate  solu- 
tion, 60  grains  of  corrosive  sublimate,  2  teaspoonfuls  of  table  salt 
to  1  gallon  of  water,  or  any  of  the  standard  disinfectants ;  and  kept 
in  a  covered  vessel  for  at  least  one  hour  before  emptying.  Disin- 
fection must  also  extend  to  the  patient's  soiled  body,  clothing,  and 
bedding,  and  to  the  hands  of  the  nurse.  If  this  is  not  done  there 
is  danger  from  so-called  contact  infection.  Infected  fingers  may 
contaminate  the  food,  while  a  fly  alighting  upon  a  soiled  part  may 
carry  the  germs  on  its  feet  to  the  food  and  drink  of  the  other  inmates 
or  even  to  some  neighboring  houses.  Prompt  and  efficient  disinfec- 
tion will  destroy  the  principal  sources  of  infection,  and  if  carried 


182  REPORTS   OF   THE   PRESIDENT'S   HOMES   COMMISSION. 

out  universally,  would  go  far  toward  removing  typhoid  fever  from 
the  face  of  the  globe.  That  this  is  possible  is  shown  by  the  fact 
that  the  typhoid  rate  in  Berlin  has  been  reduced  from  142  per 
100,000  of  population  in  1872  to  5  in  1906. 

The  causes  of  typhoid  fever  in  this  city  are  perhaps  more  complex 
and  varied  than  elsewhere ;  no  one  factor  can  alone  be  held  responsible 
for  its  undue  prevalence,  and  in  the  prevention  of  the  disease  due 
attention  must  be  paid  to  the  removal  of  all  the  causes  likely  to  influ- 
ence its  spread. 

Among  the  sanitary  measures  which  should  be  invoked  are  the 
following:  The  expenditure  of  $100,000  asked  for  by  Major  Cosby 
for  the  perfection  of  the  quality  of  the  filtered  water.  While  the 
installation  of  the  filtration  plant  has  resulted  in  an  improved  water 
supply,  it  is  found  that  during  periods  of  great  turbidity,  especially 
during  the  months  of  December  and  January,  the  number  of  bacteria 
remaining  in  the  effluent  exceeds  permissible  limits.  It  has  also 
been  shown  that  the  efficiency  of  the  filters,  as  regards  removal  of 
bacteria,  can  not  be  increased  without  previous  chemical  treatment 
of  the  water  at  such  periods.  In  view  of  the  fact  that  the  degree 
of  danger  varies  with  the  number  of  bacteria  left  in  the  water,  no 
effort  should  be  spared  to  eliminate  these  high  counts  by  the  methods 
proposed  by  the  engineer  in  charge. 

The  prevention  of  river  pollution  involves  problems  which  should 
be  solved  in  the  interest  of  this  and  other  communities  using  a  public 
water  supply  from  interstate  rivers,  under  which  circumstances  the 
inhabitants  of  one  Commonwealth  are  powerless  to  protect  themselves 
against  the  misdeeds  of  their  neighbors. 

The  abandonment  of  public  and  private  wells  and  box  privies, 
wherever  found,  the  removal  of  slums,  insistence  upon  clean  homes, 
back  yards,  basements,  cellars,  alleys,  streets,  and  vacant  lots,  and 
more  stringent  laws  for  the  production  and  sale  of  milk  and  cream, 
together  with  the  reclamation  of  the  Anacostia  Flats  can  not  fail  to 
diminish  some  of  the  contributory  factors  in  the  prevalence  of  the 
disease. 

Many  of  these  measures  have  been  urged  by  the  commissioners  and 
the  health  officer  for  years,  and  it  is  the  duty  of  every  good  citizen 
to  strengthen  their  hands  in  their  well-directed  efforts.  In  addition 
to  all  this,  there  is  special  need  for  more  visiting  nurses  and  social 
workers  to  instruct  our  neglected  neighbors  in  higher  standards  of 
living,  and  finally,  more  attention  should  be  paid  in  our  schools  to 
hygienic  and  sociological  questions,  so  that  the  average  child  may 
learn  the  essentials  for  the  preservation  and  promotion  of  health. 

DIARRHEA    AND    DYSENTERY. 

While  diarrhea  is  a  symptom  of  very  many  diseases,  there  is  reason 
for  believing  that  certain  forms,  occurring  in  infants  as  well  as  adults, 
toward  the  middle  or  close  of  a  hot,  dry  summer,  are  caused  by  the 
consumption  of  tainted  food,  milk,  impure  water,  etc.,  superinduced 
by  putrefactive  bacteria,  and  that  the  serious  forms  of  summer  com- 
plaints are  due  to  specific  germs. 

From  what  we  know  of  the  nature  and  cause  of  dysentery  we  are 
led  to  consider  it  an  infectious  disease,  which  is  spread  very  much  like 
typhoid  fever.  The  tropical  form  of  dysentery  is  caused  by  an 
ameboid  organism,  while  the  type  most  prevalent  in  this  country  is 
due  to  a  bacillus. 


REPORTS   OF   THE   PRESIDENT'S   HOMES   COMMISSION .  183 

In  our  present  state  of  knowledge  we  may  conclude  that  the  virus 
of  dysentery,  whether  of  the  bacillary  or  amebic  type,  proceeds  from 
the  intestinal  discharges  of  a  previous  case,  and  the  most  usual  mode 
of  transmission  of  the  germs  is  through  the  water  supply.  This  is 
the  opinion  of  Virchow,  based  upon  personal  experience  in  Egypt, 
and  Uffelmann  has  frequently  observed  that  persons  using  boiled 
watet  during  a  dysentery  epidemic  remained  exempt,  and  that  the 
simple  closing  of  a  suspicious  well  often  checked  the  spread  of  the 
disease.  It  is  also  perfectly  conceivable  that  the  germs  may  be  spread 
through  soils  strongly  polluted  and  infected  with  excrementitious 
matter,  and  with  particles  of  dust  gain  access  to  milk,  fruit,  fresh 
vegetables,  etc.,  which  are  eaten  raw.  The  agency  of  flies  in  carrying 
the  germs  from  infected  sources  to  the  food  supply  can  not  be 
ignored. 

Temperature  also  plays  an  important  role  in  the  development  of 
the  disease.  At  all  events,  statistics  show  that  in  temperate  climates 
the  disease  assumes  epidemic  proportions  in  July,  August,  and  Sep- 
tember, and  declines  with  the  approach  of  cold  weather ;  it  goes  hand 
in  hand,  therefore,  with  a  maximum  temperature  of  the  air  and  soil. 
It  is  also  a  clinical  fact  that  badly  nourished  individuals,  and  those 
suffering  from  indigestion  or  intestinal  catarrhs,  are  especially  liable 
to  be  attacked. 

Prophylaxis:  In  the  attempt  to  prevent  epidemic  extensions . of 
these  diseases  the  water  supply  should  be  looked  after,  and  every 
source  of  contamination  of  wells,  springs,  and  public  reservoirs  must 
be  avoided,  and  suspicious  supplies  closed. 

The  public  should  be  enlightened  as  to  the  nature  of  these  diseases, 
and  especially  of  the  necessity  for  prompt  disinfection  of  stools.  It 
should  also  be  informed  that  indigestion,  the  result  of  indiscretion  in 
eating  and  drinking,  and  chilling  of  the  body  increase  the  suscep- 
tibility ;  that  it  is  desirable  during  the  prevalence  of  these  diseases  to 
use  only  boiled  water  and  milk,  and  to  avoid  the  consumption  of 
raw  vegetables  and  fruit,  unless  they  have  been  thoroughly  washed 
with  water  previously  boiled. 

Chapter  IV.  -     ' 

INFANTILE  MORTALITY. 

According  to  Oesterlein's  statistics  it  is  safe  to  assert  that  the 
average  death  rate  during  the  first  year  of  life  is  188  out  of  1,000 
infants  born. 

According  to  the  census  of  1900  the  infantile  mortality  per  1,000 
births  in  the  so-called  registration  States  was  as  follows : 

District  of  (Columbia 274.  5 

Rhode   Island 197.  9 

Massachusetts 177.  8 

New  Hampshire 172.  6 

New  Jersey 167. 4 

New   York 159.  8 

Connecticut 156.8 

Maine 144. 1 

Vermont 122.1 

Michigan 121. 8 


184 


REPORTS  OF   THE  PRESIDENT  S  HOMES  COMMISSION. 


It  will  be  seen  that  the  rate  of  Vermont  and  Michigan  is  less  than 
one  half  that  of  the  District  of  Columbia. 

The  rates  in  foreign  countries  likewise  vary  considerably.  In 
France  the  average  rate  from  1874  to  1893  was  167 ;  in  1903  it  had 
fallen  to  137,  practically  the  same  as  that  of  New  Jersey. 

According  to  Harrington*  our  highest  rate  about  equals  Russia, 
and  it  is  not  much  greater  than  that  of  Austria.  Ehode  Island  makes 
a  better  showing  than  Germany  and  Italy.  The  German  rates  for  the 
five  years  1901-1905  were  216,  184,  202,  204,  204.  The  Italian  rates 
are  170.  Maine  stands  with  England  and  Wales,  and  better  than 
Belgium  and  the  Netherlands.  The  rates  for  England  and  Wales 
are  150;  Belgium,  156;  the  Netherlands,  147.  The  rate  of  Vermont 
is  lower  than  Scotland  (126),  Denmark  (127),  Finland  (134),  or 
Switzerland  (144).  Michigan  is  also  lower  than  Scotland  (126). 
The  following  countries  have  lower  rates:  New  South  Wales,  108; 
Victoria,  105;  Ireland,  105;  South  Australia,  102;  Queensland,  101; 
Sweden,  98 ;  Norway,  90 ;  New  Zealand,  79. 

These  are  mean  rates  for  rural  and  urban  districts.  In  towns  and 
cities  the  mortality  is  always  higher,  amounting  to  33.6  per  cent,  as 
compared  with  the  rural  mortality  of  27.8  per  cent. 

The  District  of  Columbia  in  1900  had  the  unenviable  reputation  o:^ 
leading  the  list  of  the  registration  States  in  infant  mortality,  but 
the  rate  of  Washington  as  a  city  compares  favorably  with  other 
cities. 

The  census  of  1900  gives  a  list  of  106  cities  and  towns  with  infantile 
death  rates  in  excess  of  175.  In  9  cases  the  rate  exceeded  300;  in  38 
it  was  between  200  and  280,  and  in  49  it  was  between  175  and  200. 

The  following  is  a  partial  list  of  these  cities  : 


Charleston,  S.  C 419. 5 

Savannah,  Ga 387.5 

Mobile,  Ala 344.  5 

Key  West,  Fla 311.8 

Biddeford,   Me. 811.6 

Atlanta,  Ga 306.0 

Fall  River,  Mass 304.7 

Lynchburg,  Va 301.  7 

Richmond,  Vji 300.7 

Laconia,  N.  H 294.  6 

Shreveport,  La 293.  5 

Jacksonville,   Fla 287.6 


Norfolk,  Va 284.6 

Lowell,  Mass 275.  5 

Washington,  D.  C 274.  5 

Baltimore,  Md 235.1 

New  Orleans,  La 1229.2 

Detroit,  Mich 201.2 

Philadelphia,  Pa 201.9 

Newport,  Ky 189.8 

Indianapolis,  Ind 173.5 

Kansas  City,  Mo 168.8 

Springfield,  111 167,4 

New  York,  N.  Y 189.4 


•Harrington,  Infantile  Mortality,  "Am.  Jour.  Med.  Sc,"  December,  1906. 


REPORTS   OF   THE  PRESIDENT  S  HOMES   COMMISSION. 


185 


The  following  is  a  list  of  24  German  cities  with  excessive  infantile 
death  rates: 


Chemnitz  .. 

Stettin 

Posen 

Nuremberg. 

Breslau 

Dantzig 

Halle 

Magdeburg. 
Konigsberg 

Leipzig 

Rixdorf 

Munich 

Cologne 

Plauen 

Stuttgart . . . 
Mannheim  . 

Berlin 

Brunswick  . 

Aachen 

Dresden  .... 
Strassburg.. 
Diisseldorf  . 
Karlsruhe . . 
Dortmund.. 


Infantile 
death  rate. 

Diarrheal 

infantile 

death  rate. 

270.99 

135.67 

260.54 

112.28 

i          248.29 

92.62 

247. 63 

113.80 

244.39 

98.62 

243. 19 

109. 87 

235.  71 

124. 77 

233.52 

100.73 

233. 25 

113.47 

222. 14 

121.49 

218. 49 

103.66 

217.  39 

95.33 

212.45 

93.60 

208.01 

36.25 

205.63 

74.80 

203.67 

86.46 

199.83 

87.99 

196.64 

81.22 

195. 12 

78.60 

191.29 

83.23 

190.45 

92.82 

187.  97 

82.43 

185.12 

86.17 

184.96 

61.76 

Percentage 
of  infan- 
tile deaths 
due  to  diar- 
rheal dis- 


60.07 
43.09 
37.27 
45.97 
40.36 
45.18 
52.94 
43.14 
48.65 
54.69 
47.44 
44.14 
44.06 
16.05 


44.03 
41.32 
40.28 
43.61 
48.74 
43.85 
46.55 
33.38 


In  1904,  in  the  323  German  cities  and  towns  having  populations  ex- 
ceeding 15,000  the  rate  was  202.  In  the  twelve  months  ended  June 
30,  1906,  in  32  German  cities  with  a  population  of  over  100,000, 
the  rate  was  198.     (Harrington.) 

From  the  foregoing  figures  it  appears  that  in  many  cities,  out  of 
every  1,000  children  born  alive,  over  one-third  perish  before  the  com- 
pletion of  the  first  year ;  but  fortunately  for  the  perpetuation  of  the 
human  race  the  average  infant  mortality  all  over  the  world  is  only 
about  one-sixth  of  those  born. 

Of  the  twelve  months  during  the  first  year  of  life  the  first  month 
furnishes  the  highest  mortality.  Of  the  1,233  infantile  deaths  re- 
ported in  this  city  in  1906,  222  were  due  to  premature  birth;  40  to 
congenital  debility;  28  to  malformations,  and  9  to  difficult  labor. 
The  first  month  is  followed  by  the  second,  third,  and  fourth  months, 
probably  also  because  of  diminished  vital  resistance.  The  tenth, 
eleventh,  and  twelfth  months  are  also  dangerous  months,  as  this  is 
at  the  usual  period  of  weaning  with  its  attending  danger  from  digest- 
ive diseases  incident  to  artificial  feeding.  We  have  already  referred 
to  diarrheal  diseases  as  the  principal  cause  of  infantile  mortality. 
A  mortality  of  40  per  cent  from  diarrheal  diseases  and  2.5  per  1,000 
from  tubercular  diseases  of  the  abdominal  lympathics  and  glands 
can  not  fail  to  claim  our  attention,  and  certainly  points,  with  more 
than  mere  suspicion,  to  the  fact  that  the  morbific  agent  in  these  cases 
is  introduced  into  the  body  with  the  food,  especially  unwholesome 
and  infectious  cow's  milk.  Nor  is  it  improbable  that  the  21  per  cent 
who  die  from  affections  of  the  respiratory  organs  are  largely  the 
victims  of  ignorance  as  regards  temperature  and  clothing  and  other 
environments  of  the  child.  The  infant  mortality  is  everywhere 
influenced  by  extremes  of  heat  and  cold,  but  tie  hot  months,  like 


186  REPORTS  OF   THE  PRESIDENT'S   HOMES  COMMISSION". 

July,  August,  and  September,  are  the  most  dangerous  on  account  of 
the  disastrous  attacks  of  diarrheal  diseases.  The  fatal  influence 
of  heat  is  graphically  shown  in  the  accompanying  chart.  (See 
next  page.)  The  deaths  from  diarrheal  diseases  ranged  according  to 
months,  from  5  in  January  to  108  in  July  and  58  in  August,  after 
which  there  is  a  rapid  decline.  The  same  abrupt  changes  are  noted 
in  the  large  statistical  material  of  German  cities  in  1905,  dealing 
with  128,035  deaths  under  one  year,  the  deaths  from  diarrheal 
diseases  ranging  from  1,192  in  January  to  15,863  in  August. 

High  infantile  mortality  rates  have  always  been  considered  the 
opprobrium  of  the  healing  art.  Dickson  asked  over  fifty  years  ago, 
"  How  shall  we  prevent  the  early  extinction  of  half  the  newborn 
children  of  men  ?  "  While  powerless  to  solve  all  the  mysteries  con- 
nected with  this  subject,  an  attempt  will  be  made  to  answer  the  prac- 
tical question.  Can  they  be  reduced?  Space  will  not  permit  to 
enter  into  detail  of  infant  hygiene,  but  we  must  at  least  point  out  the 
fact  that  the  mortality  can  be  greatly  reduced  by  improving  the 
original  stock,  i.  e.,  the  physique  and  habits  of  the  parents,  and  plac- 
ing them,  as  well  as  their  offspring,  under  more  suitable  environ- 
ments, especially  with  reference  to  fresh  air,  sunlight,  exercise, 
suitable  clothing,  and  habitations,  and  last  but  not  least,  proper  food. 

The  influence  of  favorable  hygienic  conditions  was  demonstrated 
by  Casper's  statistics,  published  as  early  as  1825,  showing  that  the 
infant  mortality  rate  among  royal  children  was  only  57,  as  compared 
with  345  per  1,000  among  the  infants  of  the  poor.  Of  170  deaths 
from  infantile  diarrhea,  investigated  by  Helle  in  Graz  in  1903  and 
1904,  not  one  belonged  to  a  rich  family,  and  but  9  to  the  well-to-do 
class,  while  161  belonged  to  the  poor  and  the  very  poor.  Clay  cal- 
culates that  of  every  100  children  born  in  England,  90  will  be  alive 
at  the  end  of  the  first  year  of  those  born  in  aristocratic  families,  79 
in  the  mercantile  class,  and  68  among  the  laboring  classes.  The  rela- 
tion of  infantile  mortality  to  the  occupation  of  the  women  has 
already  been  discussed  in  a  previous  report. 

Dr.  George  Reid,  at  the  National  Conference  on  Infantile  Mor- 
tality, held  in  London  in  June,  1906,  contrasted  the  infantile  mor- 
tality in  two  districts,  identical  in  health  conditions,  but  with  the 
important  difference  that  in  one  women  are  largely  employed  in 
industrial  pursuits,  and  in  the  other  there  is  practically  no  employ- 
ment for  them,  with  the  result  that  the  infantile  mortality  varied 
from  149  to  198  per  1,000. 

The  infantile  mortality  returns  in  the  United  States  also  indi- 
cate that  we  are  dealing  with  a  class  mortality,  which  is  highest  in 
communities  where  women  are  employed  in  mills  and  other  gainful 
occupations,  and  in  consequence  the  children  fall  victims  to  igno- 
rance and  neglect.  Contrast,  for  example,  the  census  rates  for  1900 
of  Fall  River,  Mass.  (304.7) ;  Lowell,  Mass.  (275.5) ;  Nashua,  N.  H. 
(261.2);  Lawrence,  Mass.  (246.5);  Manchester,  N.  H.  (238.4),  all 
typical  mill  towns,  with  the  rate  at  Cambridge,  Mass.,  which  was 
186.5.  The  seasonal  and  climatic  influences  arc  of  course  the  same 
and,  presumably,  also,  the  general  quality  of  the  milk  supply,  hence 
we  must  look  largely  to  sociological  factors  for  an  explanation,  such 
as  has  been  offered  on  pages  78-80,°  and  may  be  summed  up  in  igno- 

<»  Kober's  Industrial  Hygiene. 


MONTHLY  DEATHS  FROM   INFANTILE   DIARRHEAL  DISEASES  DURING  1906  COMPARED  WITH 
AVERAGE  MONTHLY  DEATHS  FOR  PAST  TEN  YEARS. 


Deaths 

110 
105 
100 
95 
90 
85 
80 
75 
70 
65 
60 
55 
50 
45 
40 
35 
30 
25 
12 
11 
10 
5 
0 

^ 

^ 

^ 

y- 

y^ 

^ 
/ 

^ 

/ 

^ 

/ 
y 

/ 
^ 

i 
^ 

^ 
^ 

^ 

^ 

^ 

^ 

- 

^ 

>: 

1 

Fl 

1 

R 

1 

1 

^ 

t 

^ 

m 

^ 

^ 

I 

m 

^ 

^ 

^ 

Jan. 

Feb. 

March 

April 

May      0 

ur\e 

July 

Aug. 

5ep^ 

Oc^ 

Nou. 

Dec. 

H  Deaths  from  Diarrheal  Diseases  during  1906. 
0  Average  annual  deaths  from  Diarrheal  Diseases  for  7  years. 
Reproduced  from  the  Report  of  the  Health  Officer,  District  of  Columbia,   1907. 


REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  187 

ranee  and  poverty.  The  same  explanation  applies  to  tlie  excessive 
rates  among  colored  infants  in  many  of  our  States  and  in  our  own 
city.  During  the  year  1906  the  number  of  children  under  two  years 
of  age  who  died  in  Washington  from  diarrheal  diseases  and  inflam- 
mation of  the  bowels  was  318,  146  white  and  172  colored.  The  cor- 
responding death  rate  per  100,000,  calculated  on  the  basis  of  the 
entire  population,  was  for  the  white  population  63.1  and  for  the 
colored  population  181.  If  any  further  ar^ment  is  necessary  to 
show  the  influence  of  sociological  factors,  it  will  be  found  in  the  fact 
that  1,792  of  the  2,711  infantile  deaths  investigated  by  Neuman  in 
Berlin  in  1903  occurred  in  1-room  dwellings,  754  in  2-room,  and  165 
in  3-room  and  larger  dwellings.  ^ 

The  difference  in  the  mortality  of  legitimate  and  illegitimate  chil- 
dren is  very  great  and  varies,  according  to  Uffelmann,  as  follows; 


Legitimate 
children. 

nieRitimate 
children. 

Per  cent. 
15.0 
22.9 
13.0 
14.0 

Per  cent. 

•60.0 

Austria.        .. 

36.1 

Sweden 

24.8 

85.0 

But  the  most  frightful  mortality  rates  are  everywhere  furnished 
by  the  hand  or  bottle  fed  children. 

Doctor  Newsholme,<»  the  medical  officer  for  Brighton,  England, 
states  that  breast-fed  infants  contribute  but  one-tenth  of  the  deaths 
from  infantile  diarrhea.  W.  J.  Tyson  ^  asserts  that  three-fourths  of 
the  150,000  infantile  deaths  in  Great  Britain  were  those  of  bottle-fed 
children.  Indeed,  we  have  evidence  that  of  the  54,027  infantile  deaths 
which  have  been  investigated  at  home  and  abroad  with  reference  to 
feeding,  86.6  per  cent  had  been  artificially  fed,  all  of  which  points  to 
the  fact  that  the  quality  of  the  food,  chiefly  cow's  milk,  in  hand-fed 
children,  plays  the  most  important  role.  This  assumtion  finds, 
moreover,  support  by  the  fact  that  the  infantile  death  rate  and  diar- 
rheal diseases  in  children  under  five  years  of  age  have  materially 
decreased  in  a  number  of  American  cities  since  the  enactment  of  pure- 
milk  laws,  notably  in  Buffalo,  Rochester,  Chicago,  New  York,  and 
Washington.  The  report  of  the  health  officer  of  the  District  of  Co- 
lumbia for  1906,  page  11,  says: 

High  as  is  the  infantile  mortality  rate  even  now  from  diarrhea  and  Inflam- 
mation of  the  bowels,  it  is  far  below  the  figures  that  formerly  prevailed.  Dur- 
ing the  five-year  period  1880-1884  the  death  rate  from  diarrhea  and  inflam- 
mation of  the  bowels  among  children  under  2  years  of  age  was  162  per  100,000 
per  annum.  During  the  five-year  period  1885-1889  the  average  annual  rate 
was  168.  During  the  next  period,  1890-1894,  the  death  rate  rose  to  175,  but 
in  the  year  1895  a  diminution  began.  During  the  period  1895-1899  the  death 
rate  from  the  diseases  named  was  only  135;  in  the  period  1900-1904  it  was  only 
109 ;  in  1905  it  was  104,  and  in  1906  it  was  only  97. 

The  only  explanation  for  the  fall  in  the  death  rate  from  infantile  diarrhea 
that  I  have  been  able  to  discover  is  the  enactment,  on  March  2,  1895,  of  the  law 
regulating  the  sale  of  milk  in  the  District  of  Columbia  and  the  establishment 
of  dairy  and  dairy-farm  inspection  under  the  provisions  of  that  law.     ♦     ♦     ♦ 

"Journal  of  Hygiene,  April,  1906. 

*  Journal  of  State  Medicine,  September,  1904. 


188  BEPOETS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

MATERNAL  NURSING. 

The  mortality  statistics  in  hand-fed  children  are  the  most  eloquent 
arguments  which  can  be  offered  in  favor  of  breast  feeding. 

Recent  statistics  collected  by  Von  Bunge  in  different  parts  of 
Europe  indicate  that  probably  75  per  cent  of  the  women  could  nurse 
their  children.  Budin  asserts  that  448  out  of  557  women  who  at- 
tended one  of  the  Paris  clinics  ,were  able  to  nurse  their  children. 
Madame  Dluski,  in  an  able  thesis,  maintains  that  of  every  100  healthy 
women,  when  the  necessary  conditions  of  alimentation  and  repose  are 
present,  99  are  actually  able  to  nurse  their  offspring.  The  importance 
of  maternal  .nursing  is  emphasized  in  different  parts  of  Europe  by 
popular  education,  and  by  the  enactment  of  laws  requiring,  in  indus- 
trial establishments  where  50  or  more  women  are  employed,  special 
rooms  for  maternal  nursing.  On  the  other  hand,  statistics  collected 
by  Hegar  in  large  obstetrical  institutions  in  Germany  indicate  that 
only  about  50  per  cent  of  women  are  capable  of  nursing  their  offspring 
for  merely  a  few  weeks,  and  the  question  naturally  arises :  What  are 
the  causes  of  this  inability  to  discharge  their  sacred  maternal  duties  ? 
Among  them  may  be  mentioned  physicial  inability  as  a  result  of  in- 
sufficient or  improper  food,  hard  work,  care,  hereditary  debility  and 
disease,  tuberculosis,  alcoholism  of  the  woman's  own  father,  modified 
syphilis,  or  nervous  diseases  in  the  family.  Von  Bunge  believes  that, 
apart  from  actual  disease  in  the  mother,  alcoholism  is  one  of  the  chief 
causes,  as  the  daughters  of  the  third  generation  of  alcoholics  are 
usually  unable  to  nurse  their  offspring.  The  effects  of  hard  work 
and  gainful  occupations  have  been  pointed  out,**  but  there  is  absolutely 
no  excuse  for  mothers  who,  although  physically  able-bodied,  are  dis- 
inclined to  nurse  their  children,  chiefly  as  a  matter  of  ease,  comfort, 
and  social  pleasures,  and  who,  instead  of  employing  a  healthy  wet- 
nurse,  prefer  artificial  feeding,  and  often  resort  to  patent  baby  foods. 

Dr.  Henry  D.  Fry,^  professor  of  obstetrics,  Georgetown  University, 
in  his  excellent  monograph  on  maternity,  states  that  such  foods  are 
more  often  the  cause  of  scurvy  than  other  nourishment.  On  page  149 
he  says: 

Pictures  of  fat  babies  smile  at  us  from  the  pages  of  newspapers  and  maga- 
zines, and  the  advertisements  say  they  were  raised  on  this  or  that  food  product. 
Unfortunately,  many  babies  have  been  raised  to  "  worlds  unl^nown,"  but  we  do 
not  see  their  pictures.  The  evidence  of  this  must  be  sought  in  graveyards,  where 
tombstones  bear  silent  witness  to  the  high  rate  of  mortality  in  early  life. 

These  remarks  are  equally  applicable  to  the  pernicious  use  of 
**  soothing  "  and  "  teething  "  sirups,  "  babies'  friend,"  etc. 
Professor  Jacobi ''  offers  some  excellent  advice  when  he  says : 

Infants  are  the  future  citizens  of  the  Republic.  Let  the  Republic  see  that 
no  harm  accrue  from  the  incompetence  or  unwillingness  to  nurse.  *  ♦  ♦ 
From  a  physical,  moral,  and  socio-political  point  of  view,  there  is  only  one 
calamity  still  graver,  that  is  to  refuse  to  have  children  at  all.  ♦  ♦  *  The 
human  society  of  the  future  will  have  to  see  to  it  that  no  poverty,  no  cruel 
labor  laws,  no  accident,  no  luxurious  indolence  must  interfere  with  the  nursing 
of  infants. 

•  Kober's  Industrial  Hygiene,  p.  78. 
»  Fry,  Henry  D.,  "  Maternity,"  1907. 

•  The  History  of  Pediatrics,  etc.,  "  Jour.  Am.  Med.  Asso.,"  November  5,  1904. 


BEPORTS   OP  THE  PRESIDENT  S  HOMES  COMMISSION.  189 

We  are  building  hospitals  for  the  sick  of  all  classes ;  asylums  for  the  insane, 
neuropathies,  and  drunliards;  nurseries  and  schools  for  epileptics,  cretins, 
and  idiots;  refuges  for  the  dying  consumptives,  and  sanatoria  for  incipient 
tuberculosis.  We  are  bent  upon  curing  and  upon  preventing.  Do  we  not 
begin  at  the  wrong  end?  We  allow  consumptives  and  epileptics  to  marry  and 
to  propagate  their  own  curse.  We  have  no  punishment  for  the  syphilitic  and 
gonorrheic  who  ruins  a  woman's  life  and  impairs  the  human  race.  Man, 
however,  should  see  that  his  kind  must  not  suffer.  One-half  of  us  should  not 
be  destined  to  watch  and  nurse  and  support  the  other  half.  Human  society 
and  the  state  have  to  protect  themselves  by  looking  out  for  a  healthy,  uncon- 
taminated  progeny.     Laws  are  required  to  accomplish  this.     *     *     * 

As  a  matter  of  fact,  Indiana,  Wisconsin,  Michigan,  and  Connecti- 
cut have  laws  prohibiting  the  marriage  of  epileptics.  Indiana  also 
prohibits  marriages  of  persons  suffering  from  transmissible  diseases, 
and,  by  an  act  of  1907,  "confirmed  criminals,  imbeciles,  idiots,  and 
rapists,  procreation  by  whom  is  deemed  inadvisable  by  experts,  shall 
be  unsexed  by  surgical  operation." 

Until  there  is  greater  perfection  in  the  physical,  moral,  and  eco- 
nomical conditions  of  the  human  race,  there  will  always  be  a  large 
percentage  of  infants  deprived  of  their  natural  food.  In  order  to 
appreciate  the  dangers  of  artificial  feeding  it  may  be  well  to  point 
out  briefly  some  of 

THE  ANATOMICAL  AND  PHYSIOLOGICAL  CHARACTERISTICS  OF  INFANTS. 

The  average  weight  of  a  healthy  newborn  male  child  is  3,500 
grams,  and  of  a  female  3,000  grams;  at  the  expiration  of  the  first 
month  the  child  should  weigh  about  one-third  more  than  at  birth; 
during  the  middle  of  the  fifth  month  it  should  have  doubled  its 
weight,  and  at  the  completion  of  the  first  year  it  should  weigh  three 
times  its  original  weight. 

At  the  end  of  the  second  year  the  normal  child  should  weight  about 
12,000  grams,  or  a  little  over  26  pounds.  Any  decided  variation 
should  cause  the  mother  to  seek  proper  advice.  It  should  also  be  re- 
membered that  the  anatomical  elements  of  the  digestive  tract  of  in- 
fants are  very  delicate  and  vulnerable  and  especially  susceptible  to 
injurious  influences,  such  as  cold  or  improper  food,  atmospheric 
temperature,  etc.  The  saliva,  up  to  the  tenth  month,  is  scant  and  in- 
capable to  any  considerable  extent  of  converting  starchy  food  into 
sugar,  a  property  only  fully  developed  about  the  expiration  of  the 
ninth  month. 

The  muscular  coats  of  the  stomach  are  delicate,  and  vomiting  is 
easily  provoked ;  the  gastric  glands  secrete  a  juice  which  is  less  acid 
than  in  after  years,  and  the  contents  are  passed  from  the  stomach  into 
the  upper  intestinal  canal  at  intervals  of  one  and  three-fourths  hours. 
The  pancreatic  juices  for  the  first  few  months  in  life  are  scant,  and  up 
to  the  fourth  or  sixth  week  incapable  of  converting  starch  into  sugar, 
but  fully  prepared  to  digest  the  proteids  and  fats  of  the  milk.  The 
stools  of  a  normal  infant  scarcely  exceed  two  or  three  during  the 
twenty-four  hours ;  they  are  of  a  semiunctuous  consistency  and  orange 
or  egg-yellow  in  color. 

There  can  be  no  question  that  the  natural  food  is  breast  milk  from 
a  healthy  mother — no  other  food  insures  to  the  same  extent  the 
physiological  development  of  the  child.  A  normal  infant  requires  a 
daily  supply  of  milk  to  the  amount  of  about  one-seventh  of  its  weight. 


190  BEPOBTS  OP  THE  PBESIDENT's  HOMES  COMMISSION. 

The  average  composition  of  human  milk,  after  the  regularity  of 
lactation  has  been  established,  is  about  as  follows:  Water,  87.30  per 
cent;  proteids,  1.5  per  cent;  fats,  4  per  cent;  sugar,  7  per  cent;  and 
mineral  salts,  0.2  per  cent.  The  composition  of  the  milk  is  by  no 
means  constant,  and  is  influenced  by  a  number  of  factors,  such  as  the 
age  of  the  mother,  food,  habits,  emotions,  race,  physical  peculiarities, 
etx3.  The  digestibility  of  human  milk  is  nearl}^  perfect,  as  97  per  cent 
is  generally  utilized;  all  of  the  constituents  are  absolutely  essential 
to  health  and  a  proper  growth  of  the  body. 

CARE    OF    TPIE    BREASTS. 

The  mother  should  take  special  care  of  the  nipples  and  breasts  and 
can  prevent  much  physical  suffering,  from  local  inflammatory  affec- 
tions, by  washing  the  parts  after  each  nursing  with  plain  water  and 
careful  drying. 

It  is  very  doubtful  whether  the  practice  of  washing  the  nipples 
during  the  last  three  months  of  pregnancy  with  alcohol  and  astringent 
lotions  is  productive  of  good ;  indeed.  Professor  Fry  *  believes  they 
are  harmful  by  drying  up  the  secretions  of  the  sebaceous  glands  and 
making  them  more  liable  to  crack,  and  he  recommends  instead  the 
application  of  cocoa  butter,  lanolin,  albolene,  vaseline,  or  castor  oil. 

Much  can  be  done  at  the  outset  in  preventing  sunken  or  depressed 
nipples  by  avoidance  of  tight  clothing,  but  when  they  do  occur  they 
should  be  treated  by  the  attending  physician. 

FREQUENCY  OF  NURSING. 

There  is  nothing  to  justify  the  frequent  practice  of  administering 
to  newborn  infants  different  teas  and  sweetened  water  during  the 
first  few  days  after  birth.  Plain  boiled  water,  at  a  temperature  of 
99,  may  be  given ;  but  above  all  we  should  endeavor  to  establish  regu- 
lar habits  at  the  outset  and  avoid  overfeeding.  Professor  Heubner 
believes  that  the  number  of  feedings  heretofore  advocated  is  too 
^eat,  and  a  less  number  is  productive  of  better  results.  In  this  he 
IS  supported  by  other  competent  observers,  and  Doctor  Schereschew- 
sky,^  in  his  excellent  article  on  "  Infant  Feeding,"  gives  the  following 
schedule,  which  seems  to  fulfill  the  best  practice  in  this  direction : 


Age.  in  24        during     Night 


Nursings 

Interval 

in  24 

during 

hours. 

day.'' 

4 

6 

6 

4 

8 

2i 

7 

3 

6 

3 

5 

4 

Firstday 4  6  1 

Secondday 6  4  1 

Third  to  twenty-eighth  dav 8  2i  1 

Fourth  to  thirteenth  week 7  3  1 

Third  to  fifth  month 6  8  0 

Jifth  to  twelfth  month 5  4  0 


The  infant  during  the  first  four  or  five  days  after  birth  usually 
loses  about  8  per  cent  of  its  weight.  It  should  then  regain  lost 
weight  and  continue  to  gain  at  the  rate  of  120  to  150  grams  (4  or  5 

«Fry,  Henry  D.,  "Maternity,"  1907. 

•Bulletin  41,  Public  Health  and  Marine-Hospital  Service,  190S. 


EEPOKTS   OF   THE  PEESIDENT's  HOMES  COMMISSION.  191 

ounces)  every  week  during  the  first  three  months,  and  from  the  third 
to  the  sixth  month  it  should  gain  about  100  to  120  grams  or  from 
3^  to  5  ounces  each  week. 

By  weighing  the  baby  regularly  we  can  judge  with  precision  of  its 
general  progress.    Professor  Fry  ^  says : 

A  baby  that  is  at  a  standstill  or  losing  weight  is  not  getting  enough  food. 
Crying  under  these  circumstances  means  more  food  or  a  better  quality  of  the 
food.  In  order  to  differentiate  between  the  cries  of  hunger,  colic,  or  earache,  he 
points  out  that  a  hungry  baby  cries  after  it  has  been  nursed  and  cries  before 
the  next  feeding.  He  suggests  placing  the  finger  in  its  mouth,  when  it 
will  stop  crying  and  suck  it  for  a  moment  and  then  cry  again  at  its  disappoint- 
ment. Nursing  babies  may  be  starving  in  spite  of  an  abundant  secretion  of 
breast  milk.  The  fluid  may  be  abundant  in  quantity  but  poor  in  quality.  The 
nutritive  value  of  breast  milk  can  be  ascertained  by  a  simple  method.  Draw 
off  some  and  let  it  stand  in  a  test  tube  over  night.  If  normal  a  good  layer  of 
cream  will  form  on  top — from  3  to  4  per  cent.  If  poor  the  color  is  pale  blue  at 
first,  the  next  morning  watery,  and  the  cream  will  be  only  1  per  cent  or  a  little 
more.  Very  bad  milk  will  show  less  than  1  per  cent  of  cream.  Again,  a 
starving  baby  is  not  nourished  properly.  To  find  this  out  examine  the  skin 
over  the  tibia  (shank).  If  the  baby  is  not  getting  enough  nourishment  the 
skin  can  be  pinched  up  with  the  fingers ;  if  properly  nourished  the  skin  is  firmly 
attached  to  the  underlying  tissue  and  the  grasp  of  the  fingers  slips  over  it. 
This  point  is  demonstrated  by  examining  the  skin  on  the  back  of  anyone's 
hand.  Extend  the  fingers  and  the  skin  is  easily  picked  up,  like  that  over  the 
tibia  of  a  starving  baby.  Close  the  fist  'and  the  skin  is  tight,  as  one  will  find 
it  over  the  shank  of  a  properly  nourished  baby. 

WEANING  OF   INFANTS. 

It  is  believed  that  a  normal  woman  who  enjoys  a  good  appetite  and 
a  supply  of  good  wholesome  food,  obeying  the  ordinary  rules  of 
health,  will  have  no  difficulty  in  discharging  her  maternal  duties. 
Nature  probably  intended  that  the  infant  should  subsist  upon  breast 
milk  until  the  eruption  of  the  first  molars,  and  many  mothers  actually 
nurse  their  offspring  until  the  twelfth  or  fifteenth  month. 

If  we  can  appoint  our  OAvn  time,  the  weaning  should  be  gradual  and 
not  considered  before  the  tenth  or  twelfth  month,  especially  not  dur- 
ing the  hot  months,  provided  the  health  of  the  mother  is  good  and 
the  child  is  doing  well.  It  would  be  very  unwise  to  wean  a  sick 
child  unless  the  sickness  is  caused  by  the  mother's  milk. 

An  inadequate  supply  of  breast  milk  can  be  made  up  by  mixed  feed- 
ing, and  surely  even  a  half  supply  of  normal  mother's  milk  for  sick 
children  is  better  than  a  full  supply  of  prepared  milk. 

CONDITIONS  WHICH  MAY  COMPEL  RECOURSE  TO  ARTIFICIAL  FEEDING. 

Unfortunately,  there  are  a  number  of  reasons  which  may  render  the 
employment  of  a  wet  nurse  or  recourse  to  artificial  feeding  imperative 
at  any  period  of  lactation : 

1.  A  motherless  child,  or  when  the  mother  is  suffering  from  an 
infectious  or  communicable  disease,  such  as  tvphoid  fever,  pneumonia,' 
etc.  A  tuberculous  mother  would  not  only  aggravate  her  disease  but 
also  expose  the  child  to  infection. 

2.  Childbed  fever  and  other  severe  complications  of  the  parturient 
state,  such  as  hemorrhages,  convulsions,  inflammation  of  the  kidneys; 

•  Maternity. 


192 


BEPOETS   OF   THE  PfiESIDENT  S  HOMES  COMMISSION. 


also  in  anemic  and  in  cachectic  and  serious  nervous  conditions,  such 
as  chorea  and  epilepsy. 

3.  Inflammatory  conditions  of  the  nipples  and  breast,  because  of 
the  admixture  of  pus  and  disease  germs. 

4.  AVhen  no  milk  is  secreted,  and  deformities  and  anomalies  of  the 
nipple  and  breast  exist  which  can  not  be  corrected. 

5.  Return  of  menstrual  period  or  early  pregnancy,  if  resulting  in 
digestive  derangements  or  malnutrition  in  the  child. 

If  under  such  circumstances  the  employment  of  a  wet  nurse  is  im- 
practicable, artificial  feeding  must  be  considered  and  the  question  con- 
fronts us,  AVhat  is  the  best  possible  substitute  for  human  milk,  the 
requirements  of  which  are: 

1.  That  it  must  offer  the  same  character  and  amount  of  nutritive 
elements  and  in  the  same  proportion  as  human  milk. 

2.  The  nutritive  elements  must  be  present  in  the  same  digestible 
form  and  of  the  same  consistency,  and  should  be  introduced  into  the 
stomach  at  a  temperature  not  less  than  98°  F.  by  means  of  slow  suction 
at  proper  intervals. 

3.  This  substitute  must  not  contain  any  morbific  or  infective  agent, 
whether  originally  present  or  introduced  during  the  preparation  or 
keeping  of  the  same. 

A  moment's  reflection  upon  the  physiology  of  infantile  digestion 
will  at  once  suggest  the  propriety  of  rejecting  all  starchy  foods  before 
the  expiration  of  the  tenth  month,  except  in  very  limited  quantities 
and  previously  converted  into  maltose  by  boiling,  as  in  barley  water. 
Since  milk  is  the  natural  food  of  all  mammalia  few  will  be  disposed 
to  doubt  that  some  modification  of  cow's  milk  offers  the  best  possible 
substitute. 

COMPARISON  or  cow's  MILK  AND  HUMAN  MILK. 

The  difference  in  the  composition  is  shown  in  the  following  table: 


Woman's 
mUk. 


Cow's 
milk. 


Fat 

Proteids 

Sugar 

Baits 

Water 

Calories  per  kilo 


Percent 

4.00 

1.50 

7.00 

.20 

87.30 


Per  cerU. 

3.00 

4.50 

4.50 

.80 

87.20 


100.00 


710.50 


100.00 


700.00 


Human  milk  contains,  therefore,  less  proteids  and  salts  and  more 
fat  and  sugar.  There  appears  to  be  also  a  difference  in  the  quality 
•of  the  casein  of  the  two  secretions. 

The  addition  of  dilute*acid  in  a  test  tube  to  cow's  milk  precipitates 
the  casein  in  hard  coagula  or  lumps,  while  in  human  milk  it  separates 
into  a  fine  powder  giving  the  appearance  of  light  flocculent  curds, 
which  readily  dissolve  in  an  excess  of  acid.  Since  the  coagulum  in 
the  same  quantity  of  human  milk  is  but  one-fifth  as  large  as  that  of 
cow's  milk,  this  difference,  which  is  solely  one  of  compactness  and 
solubility,  is  believed  to  influence  the  digestibility  of  the  two  secre- 


KEPORTS   OF   THE  PEESIDENt's  HOMES   COMMISSION.  193 

tions.  This  statement  has  been  questioned,  however,  by  Heubner, 
whose  studies  indicate  that  when  the  test-tube  experiments  are  carried 
on  to  imitate  the  movements  of  the  stomach  the  resulting  curd  is  quite 
as  fine  as  the  curd  of  human  milk.  He  also  verified  his  conclusions 
by  withdrawing  cow's  milk  shortly  after  ingestion  by  infants  with  a 
stomach  tube.  Admitting  that  Heubner  is  correct  in  assuming  that 
cow's  milk  contains  the  same  constituents,  but  in  different  proportions, 
which  can  be  corrected  by  modifying  it,  there  still  remain  differences 
which  are  important,  especially  the  fact  that  human  milk  is  always 
fresh  and,  from  a  healthy  mother,  rarely  contains  micro-organisms, 
while  cow's  milk  is  never  free  from  bacteria,  and  may,  moreover,  be 
the  vehicle  of  infectious  germs  and  other  morbific  agents. 


1.  It  has  been  shown  that  certain  diseases  in  the  cow  are  commu- 
nicable to  man  through  the  medium  of  the  milk.  This  is  especially 
true  of  tuberculosis,  foot-and-mouth  disease,  anthrax,  and  cowpox. 
The  writer,  in  1903,  published  86  cases  of  milk-borne  tuberculosis, 
and  Doctor  Salmon  has  shown,  from  the  vital  statistics  of  Massachu- 
setts and  Michigan,  that  while  there  has  been  a  marked  reduction  in 
the  mortality  of  phthisis  at  all  other  ages,  there  has  been  a  tremendous 
increase  in  the  class  under  5  years  of  age.  There  is  also  evidence  to 
show  that  diseases  like  garget,  inflammation  of  the  udder  and  teats, 
digestive  derangements,  and  septic  fevers  in  the  cow  will  render  the 
milk  morbific  to  man. 

2.  It  has  been  shown  that  cows  which  have  been  fed  on  poisonous 
forage  plants,  or  have  been  treated  with  strong  medicaments  for  any 
or  all  causes,  are  disqualified  from  producing  a  pure  or  sound  milk. 

3.  The  writer  has  collected  and  taubulatea  the  history  of  195  epi- 
demics of  typhoid  fever,  99  of  scarlet  fever,  and  36  of  diphtheria,  all 
traceable  to  the  milk  supply.  In  a  recent  investigation  into  the 
causes  of  typhoid  fever  in  Washington,  the  bureau  of  public  health 
definitely  traced  85  out  of  866  (about  10  per  cent)  to  infected  milk. 

Last  but  not  least  the  writer  desires  to  emphasize  two  important 
milk  faults  which  may  be  considered  sources  of  constant  danger  in 
infant  feeding,  and  perhaps  the  most  important  factors  in  swelling 
the  mortality  rates  of  our  helpless  babes,  viz,  milk  sediments  (dirty 
milk)  and  their  effects  on  premature  acidity. 

MILK  SEDIMENTS  OR  DIRTY  MILK. 

Every  consumer  of  milk  has  doubtless  observed  the  presence  of 
more  or  less  foreign  matter  at  the  bottom  of  the  bottle  in  which  it  is 
kept ;  indeed,  it  is  a  matter  of  such  common  occurrence  that  it  hardly 
excites  our  attention,  and  many  are  disposed  to  look  upon  it  as  a  matr 
ter  of  course.  Professor  Soxhlet,  of  Munich,  was  perhaps  the  first  to 
point  out  that  these  deposits  are  largely  made  up  of  excrementitious 
matter  from  the  cow,  which,  adhering  to  the  udder  of  the  animal, 
gained  access  to  the  bucket  during  the  act  of  milking.  If  these  sedi- 
ments are  subjected  to  microscopical  examination  we  will  find  that 
they  are  composed  of  epithelial  debris,  hairs  of  the  cow,  organic  and 
inorganic  dust  particles,  excrementitious  matter,  vegetable  fibers, 
S.  Doc.  644,  60-2 14 


194  REPORTS   OF   THE   PRESIDENT'S   HOMES   COMMISSION. 

bacteria,  fungi,  and  spores  of  every  description ;  fully  90  per  cent  of 
the  germs  are  fecal  bacilli — all  of  which  is  not  only  disgusting  but 
extremely  suggestive  of  danger.  The  number  of  micro-organisms  is 
largely  increased,  and  we  know  that  under  a  suitable  temperature  bac- 
terial development  and  consequent  decomposition  are  materially  has- 
tened in  such  a  medium. 

The  greatest  danger  from  milk  of  this  class  is  the  possible  presence 
of  ptomains  or  toxins  produced  b}^  certain  saprophytic  germs  acting 
on  the  albuminoids  of  the  milk.  Professor  Vaughan,  of  Ann  Arbor, 
Mich.,  in  1885,  isolated  a  poison  called  tyrotoxicon,  which  is  one  of 
the  causes  of  the  toxic  symptoms  in  some  cases  of  milk  poisoning, 
cheese  and  ice-cream  poisoning.  The  presence  of  the  very  filth  re- 
ferred to,  a  summer  temperature,  and  the  pernicious  habit  of  placing 
the  milk  before  cooling  in  cans  and  bottles  perhaps  dirty  besides,  con- 
stitute favorable  environments  for  the  development  of  this  and  analo- 
gous poisons. 

Germ  development  and  acidity  of  the  milk  are  influenced  by  tem- 
perature. Milk  when  it  leaves  the  udder  of  the  cow  contains  very 
few  germs;  the  majority  gain  access  during  unclean  handling,  espe- 
cially when  the  milking  is  done  in  a  dirty  stable,  or  from  excrementi- 
tious  matter  adhering  to  the  udder  and  teats  of  the  animal.  These 
germs  multiply  with  astonishing  rapidity  whenever  the  temperature 
of  the  milk  is  above  50°  F.,  and  if  disease  germs  are  present  their 
proliferation  augments  the  chances  of  infection.  A  temperature  of 
58°  or  60°  F.  will  not  subserve  the  interest  of  public  health.  So,  for 
example,  Petruschky  has  shown  that  at  the  room  temperature  a 
streptococcal  content  of  300  per  cubic  centimeter  may  increase  in 
twenty-four  hours  to  one  of  10,000,000,  but  the  same  milk  kept  at  50° 
F.  yielded  but  30,000,  or  but  three  one-thousandths  as  many. 

Von  Freudenreich  ("Dairy  Bacteriology,"  London,  1895)  exposed 
a  sample  of  milk  containing  153,000  bacteria  per  cubic  inch  to  a 
temperature  of  59°  F.;  one  hour  after  it  contained  539,750  bacteria 
per  cubic  inch;  two  hours  after,  616,250;  four  hours  after,  680,000; 
seven  hours  after,  1,020,000;  nine  hours  after  2,040,000;  twenty-five 
hours  after,  85,000,000. 

Bryce,  of  Toronto,  has  made  similar  investigations.  All  of  which 
indicates  the  extent  of  germ  development  which  must  go  on  in  milk 
transported  over  long  distances  during  the  summer  months,  when  the 
mercury  ranges  from  85°  to  95°  and  the  cans  are  allowed  to  stand  in 
the  sun  without  ice;  and  we  can  appreciate  why  even  100,000,000  of 
bacteria  per  cubic  centimeter  have  been  found  in  samples  of  Wash- 
ington milk,  far  exceeding  the  number  usually  found  in  the  sewage 
of  cities.  Other  cities  are,  however,  similarly  afflicted,  and  nothing 
short  of  clean,  decent  habits  in  handling  the  milk  and  keeping  it  at 
a  temperature  of  50°  F.  will  prevent  the  mischief.  Dr.  H.  C.  Plant, 
of  Leipzig,  found,  as  a  rule,  that  in  warm  weather  the  so-called  fresh 
milk  delivered  in  the  morning  is  unfit  for  young  children,  and  of  47 
infants  whose  milk  supply  was  carefully  investigated  by  him  18  de- 
veloped serious  digestive  and  intestinal  diseases,  and  6  died.  One  of 
the  chief  reasons  why  there  are  less  deaths  from  infantile  diarrhea 
in  the  country  than  in  towns  and  cities,  in  proportion  to  the  popula- 
tion, is  that  the  milk  used  is  comparatively  fresh,  contains  fewer 
germs  and  less  toxins.  Without  doubt  dirty  and  sour  milk,  or  milk 
which  is  on  the  point  of  turning,  are  the  chief  causes  of  diarrheal 


KEPORTS    OF   THE  PRESIDENT'S   HOMES   COMMISSION.  195 

diseases  in  bottle-fed  children,  and  in  the  more  acute  cases  we  have 
the  phenomena  of  cholera  infantum,  due  most  likely  to  a  toxic  char- 
acter of  the  milk.  These  views  have  steadily  gained  ground  and 
have  resulted  in  great  sanitary  reforms  in  our  milk  establishments, 
the  fruits  of  which  are  already  apparent  in  the  decrease  of  deaths 
from  infantile  diarrhea  in  this  city.     (See  page  187.) 

PRODUCTION    or   PURE    MILK. 

The  Washington  market  milk  compares  favorably  with  the  supply 
in  other  cities ;  there  is  no  evidence  to  shoAv  that  it  is  worse,  but  there 
is  abundant  evidence  to  indicate  that  stale,  dirty,  and  infected  mar- 
ket milk  is  everywhere  responsible  for  a  needless  sacrifice  of  human 
life,  and  it  is  clearly  the  duty  of  the  State  to  take  what  precautions 
it  can  to  prevent  sickness  and  distress. 

Those  who  are  familiar  with  the  surroundings  of  our  milk  farms 
and  the  habits  of  the  average  dairy  employee  need  no  arguments  for 
the  necessity  for  sanitary  reforms,  and  the  principles  which  ought  to 
be  carried  out  should  be  embodied  in  effective  laws  and  accepted  and 
enforced  in  a  practical  sense.  Honorable  men  will  not  object  to  regu- 
lations calculated  to  promote  the  purity  of  their  product  and  the 
health  of  their  customers,  and  as  many  of  the  most  serious  faults  in 
the  milk  business  are  the  result  of  ignorance  rather  than  of  inten- 
tional neglect,  the  difficulties  will  be  materially  lessened  by  proper 
education  and  trade  competition. 

Pure  natural  milk  can  only  be  secured  at  dairies  with  sanitary 
buildings,  a.  pure  water  supply,  healthy,  well-fed,  and  well  cared  for 
cows,  a  well -equipped  and  well-kept  milk  room,  provisions  for 
thorough  cleanliness,  intelligent  and  conscientious  people  in  charge, 
and  clean  methods  throughout. 

CERTIFIED  MILK.* 

It  was  in  consequence  of  a  just  appreciation  of  these  principles 
that  the  so-called  "  certified  milk "  came  into  existence  about  ten 
years  ago.  Responsible  bodies  of  citizens  interested  in  an  improved 
milk  supply  organized  in  different  cities  milk  commissions.  Such 
commissions  usually  select  and  secure  the  advice  and  assistance  of 
four  experts — a  veterinarian,  a  physician,  a  bacteriologist,  and  a 
chemist — all  more  or  less  familiar  wdth  the  conditions  and  possibili- 
ties on  dairy  farms.  The  commission  sends  to  each  dairyman  who 
supplies  milk  to  the  city  a  circular  naming  all  the  particular  condi- 
tions which  should  be  found  on  every  farm  where  milk  is  produced 
for  city  use,  and  announcing  that  where  any  dairyman  notifies  the 
commission  that  he  is  fully  conforming  to  the  conditions  specified, 
or  endeavoring  to  do  so,  his  dairy  will  be  inspected,  and,  if  it  is  found 
to  comply  in  letter  and  spirit  to  all  the  requirements,  his  name  will 
be  placed  upon  an  approved  list  and  he  will  receive  official  indorse- 
ment to  the  effect  that  his  dairy  farm  and  the  herd  thereon  have 

«  Extract  from  a  Report  of  the  Committee  on  Sanitary  Relations  to  a  con- 
ference appointed  by  the  Commissioners  of  the  District  of  Colmnbia  to  consider 
and  report  upon  the  local  milk  supply.  The  writer  was  chairman  of  the  sub- 
committee which  submitted  the  report. 


196  EEPORTS   OF   THE   PRESIDENT'S   HOMES   COMMISSION. 

been  thoroughly  examined  and  found  to  comply  with  the  conditions 
recommended  by  the  commission.  These  conditions  include  a  healthy 
herd,  the  use  of  pure  feeds,  appropriate  stabling  and  care,  pure 
water,  and  clean  and  prompt  handling  of  the  milk,  which  is  of  good 
composition  and  quality  and  so  free  from  pathogenic  and  unneces- 
sary bacteria  as  reasonable  safeguards  can  provide.  The  attendants 
are  cleanly  and  free  from  communicable  diseases,  and  all  milk  is 
promptly  cooled,  immediately  after  milking,  to  a  temperature  of  50° 
F.  Every  intelligent  dairy  farmer  insists  upon  cooling  his  milk  as 
soon  as  the  bucket  is  full. 

The  inspections  are  made  unannounced  and  at  irregular  intervals, 
so  as  to  insure  maintenance  of  the  prescribed  standard.  Any  neg- 
lected condition  is  immediately  reported  to  the  commission,  which 
decides  whether  or  not  the  cause  is  sufficient  to  withdraw  and  cancel 
the  last  certificate  issued. 

PASTEURIZED     MILK. 

It  must  be  apparent  that  it  will  require  time  and  education  to 
secure  compliance  with  even  reasonable  safeguards,  and  it  is  equally 
evident  that  the  number  of  dairy  farms  now  in  a  position  to  live  up 
to  sanitary  requirements  will  supply  but  a  small  percentage  of  the 
population,  although  it  is  hoped  that  such  dairy  farms  will  be  stimu- 
lated into  existence  by  trade  competition  and  the  refusal  of  the  public 
to  buy  dirty  milk  at  any  price.  Until  this  is  accomplished,  the  com- 
mittee, in  the  interest  of  public  health,  strongly  advocates  clarification 
and  pasteurization  of  all  milk.  This,  to  be  sure,  will  not  make  bad 
milk  good,  but  it  will  at  least  destroy  its  power  to  transmit  disease 
germs. 

PASTEURIZING   PLANTS    OR   MILK   DEPOTS. 

Your  committee  also  believes  that  this  object  can  be  most  efficiently 
Aiid  economically  secured  by  the  establishment  of  a  pasteurizing  plant 
provided  by  the  District  government  or,  preferably,  by  private  enter- 
prise, which  plant  should  be  under  the  supervision  of  the  health 
department. 

There  is  every  argument  from  a  commercial  and  sanitary  stand- 
point in  favor  of  a  central  plant,  erected  within  reasonable  distance 
from  the  Union  Depot,  where  all  the  milk  for  the  city  should  be  re- 
ceived and  prepared  for  distribution.  Such  a  step  would  result  in 
the  creation  of  suitable  conditions  for  the  proper  handling  and  stor- 
age of  milk,  sterilization  of  milk  cans  and  utensils,  and  the  efforts  of 
the  local  milk  dealers  to  provide  decent  facilities  for  their  150  or 
more  dairies  scattered  over  the  city,  all  more  or  less  liable  to  infection, 
could  be  concentrated  in  one  plant  with  a  decided  saving  of  expense. 

Milk  should  never  be  sold  by  grocery  stores  or  milk  shops  unless  it 
has  been  delivered  to  such  establishment  in  original  sealed  bottles,  and 
then  only  when  there  is  provision  for  maintaining  the  milk  at  a  tem- 
perature of  50°  F. 

ADVANTAGES   AND    DISADVANTAGES   OF   PASTEURIZED    MILK. 

Your  committee  is  aware  that  there  is  a  difference  of  opinion  among 
medical  men  as  to  the  wholesomeness  of  pasteurized  milk.  The  ad- 
vantages and  disadvantages  have  been  exhaustively  studied  by  Dr. 


BEPORTS   OF    THE   PRESIDENT'S  HOMES   COMMISSION.  197 

M.  J.  Rosenau,  director  of  the  Hygienic  laboratory  of  the  United 
States  Bureau  of  Public  Health  and  Marine-Hospital  Service,  and 
in  his  opinion  the  advantages  so  far  outweigh  the  disadvantages  that 
he  "  unhesitatingly  recommends  compulsory  pasteurization  of  all  milk 
not  certified  under  class  1  or  class  2  of  Doctor  Melvin's  classification."  «* 
Your  committee  is  so  strongly  impressed  with  the  manifold  dangers 
connected  with  the  milk  supply  that  until  the  needful  reforms  in 
dairy  methods  are  accomplished  it  recommends  to  the  public  the  fol- 
lowing as  immediate  safeguards : 

1.  Do  not  patronize  a  milk  dealer,  at  any  price,  whose  milk  after 
standing  for  two  hours  reveals  a  visible  sediment  at  the  bottom  of  the 
bottle.  It  is  evidence  of  dirty  habits,  extremely  suggestive  of  danger, 
and  entirely  preventable  by  clean,  decent  methods  without  greatly 
increasing  the  cost. 

2.  Subject  all  your  milk  to  home  pasteurization  by  simply  bringing 
it  to  the  boiling  point,  and,  after  cooling,  keep  the  milk  on  ice.  This 
will  destroy  germ  life  and  reduce  the  chances  of  milk-borne  diseases 
to  a  minimum. 

Dr.  H.  W.  Wiley's  committee  submitted  the  following  recommenda- 
tions : 

1.  That  the  milk  which  is  supplied  to  infants  under  the  age  of  3  years  in 
the  District  of  Columbia  should  be  certified  by  the  health  office.  Milk  should 
contain  not  more  than  5,000  bacteria  per  centimeter,  should  be  not  more  than  12 
hours  old,  and  should  be  delivered  in  artificially  cooled  packages. 

2.  That  the  health  oflEicer  of  the  District  be  authorized  to  advertise  for  dairies 
which  will  be  willing  to  so  modify  their  barns,  stables,  etc.,  if  necessary,  as  to 
secure  a  license  from  him  for  the  production  of  certified  milk  under  the  most 
improved  sanitary  conditions. 

3.  That  each  cow  furnishing  the  milk  in  the  dairy  be  tested,  under  the 
supervision  of  the  health  officer,  for  tuberculosis  or  other  contagious  or  infec- 
tious diseases;  and  that  any  animal  so  suffering  be  excluded  from  the  herd. 

4.  That  a  daily  sample  or  samples  drawn  from  the  supply  of  each  certified 
milk  furnished  to  the  city  be  secured  for  the  purpose  of  making  the  bacterial 
count  and  determining  the  chemical  composition,  etc. 

5.  That  parents  and  guardians  be  urged  to  use  only  certified  milk,  at  least 
for  infants'  food,  in  the  District  of  Columbia  for  all  infants  under  the  age  of 
3  years. 

6.  That  if  private  dairies  can  not  be  induced  to  furnish  certified  milk,  the 
Commissioners  of  the  District  of  Columbia,  as  a  health  measure  affecting  in 
the  highest  degree  the  welfare  of  the  District  of  Columbia,  be  asked,  if  it  can 
be  legally  done,  to  establish  a  municipal  dairy  for  the  purpose  of  furnishing 
certified  milk  for  the  use  of  infants  under  3  years  of  age. 

7.  That  pending  the  time  which  must  necessarily  elapse  for  the  inauguration 
of  a  service  of  certified  milk  for  infants'  use,  the  health  officer  be  authorized, 
as  a  result  of  inspection,  to  publish  a  list  of  dairies  from  which  the  milk 
supply  is  drawn,  giving  the  average  rating  of  each  dairy,  the  chemical  com- 
position, and  bacterial  count  of  the  samples. 

8.  That  for  the  purpose  of  securing  modified  milk  for  infants  in  ill  health, 
according  to  the  prescription  of  physicians,  the  milk  commission  of  the  Dis- 

oThe  classification  referred  to  is  as  follows:  Class  1,  certified  milk  for  infants, 
as  hereinbefore  described.  Class  2,  clean,  raw  milk  from  healthy  cows,  as 
determined  by  the  tuberculin  test  and  veterinary  physical  examination;  the 
cows  to  be  housed,  fed,  and  milked  under  good  conditions,  but  not  necessarily 
equal  to  the  conditions  provided  for  in  class  1;  pure  water,  as  determined  by 
chemical  and  bacteriological  examination,  to  be  provided;  the  bacteriological 
count  of  the  milk  not  to  exceed  100,000  bacteria  per  cubic  centimeter,  at  the 
time  the  milk  reaches  the  city,  at  any  season  of  the  year,  as  determined  by  the 
health  department  at  frequent  intervals;  milk  to  be  delivered  to  the  customer 
in  sterilized  containers,  to  be  filled  upon  the  dairy  farm,  and  the  temperature  of 
the  milk  not  to  exceed  50°  F.  until  delivered  to  the  customer. 


198  KEPOKTS   OF   THE   PRESIDENT'S   HOMES   COMMISSION. 

trict  Medical  Society  be  requested  to  secure  the  establishment  of  a  laboratory, 
under  its  supervision,  in  which  only  certified  milk  shall  be  used,  and  in  which, 
by  the  use  of  a  separator  or  otherwise,  milk  of  a  definite  chemical  composition 
may  be  prepared  from  certified  milk,  in  harmony  with  the  physicians'  pre- 
scriptions relating  thereto. 

9.  That  a  complete  chemical  and  bacteriological  laboratory  be  established 
in  connection  with  the  health  office,  of  a  capacity  to  examine  all  the  samples 
necessary  to  secure  the  certified  and  modified  milks  above  described. 

10.  That  the  term  "certified  milk,"  as  used  herein,  is  to  be  applied  to  mill- 
secured  at  dairies  subject  to  a  periodic  inspection,  and  the  products  of  which 
are  subjected  to  constant  analysis.  The  cows  providing  the  milk  are  properly 
fed,  free  from  tuberculosis  or  other  contagious  diseases,  and  housed  in  clean 
stables,  properly  ventilated,  and  they  are  supplied  with  wholesome  water  and 
food,  and  kept  clean.  The  milk  is  drawn  under  precautions  to  avoid  infection, 
is  immediately  strained  and  cooled  and  packed  in  sterilized  bottles,  which  are 
kept  at  a  temperature  not  to  exceed  50°  F.  until  delivered  to  the  consumer. 

It  is  fully  realized  that  milk  of  this  character  will  cost  more  to 
produce  and  should  bring  a  higher  price  in  the  market  than  ordinary 
uncertified  milk.  At  the  same  time  it  is  hoped  that  the  producers 
of  milk  will  endeavor  to  keep  the  prices  within  the  means  of  the 
ordinary  citizen  while  making  a  fair  profit  on  their  invested  capital. 

In  the  language  of  Professor  Harrington,  "  the  public  needs  proper 
education  that  clean  milk  is  a  necessity,  and  that  infant  sickness  and 
funerals  can  be  reduced  at  least  40  per  cent.  *  *  *  j^  model  farm 
properly  manned  certainly  can  not  compete  on  equal  terms  with  a 
filthy  farm,  where  no  attempt  is  made  to  conduct  the  business  in  a 
decent  manner,  especially  if  customers  are  indifferent.  The  dirty 
producer  can  e^fe'n  afford  to  cut  prices  and  take  customers  away  from 
the  other,  if  customers  care  to  save  a  cent  and  make  it  up  in  pus  and 
cow  dung." 

HOME    TREATMENT    OF    NURSERY    MILK.« 

The  milk,  as  soon  as  delivered,  should  be  placed  in  a  refrigerator 
upon  ice,  so  that  the  temperature  may  not  exceed  50°  F.  If  desired 
for  infant  feeding,  it  should  stand  for  one  hour,  when  the  upper 
third  (10  per  cent  top  milk)  can  be  taken  off.  This  top  milk  is  then 
modified,  so  that  the  proportion  of  the  constituents  may  be  those  of 
human  milk.  This  is  done  by  mixing  7  ounces  of  the  top  milk  with 
1  ounce  or  2  tablespoonfuls  of  milk  sugar,  the  same  quantity  of  lime- 
water,  and  12  ounces  of  boiled  water.  If  only  10  ounces  be  required 
for  twenty-four  hours'  feeding,  the  proportion  of  each  ingredient  is 
reduced  one-half;  if  30  ounces  be  necessary,  add  one-half.  In  case 
the  child  presents  evidence  of  feeble  digestion,  the  amount  of  fats  and 
proteids  must  be  reduced  by  cutting  down  the  top  milk  to  6,  5,  4,  3, 
or  even  2  ounces,  and  sufficient  boiled  water  added  to  make  20  ounces. 
After  modifying  the  milk  in  the  manner  directed,  the  correct  amount 
of  each  feeding  is  put  in  a  nursing  bottle.  The  necks  of  the  bottles 
are  stopped  up  with  plugs  of  clean  nonabsorbent  cotton. 

The  milk  should  then  be  pasteurized.  For  this  purpose  different 
pasteurizers  have  been  placed  on  the  market.  A  very  simple  and 
inexpensive  method  is  to  place  the  bottles  in  a  tin  kettle,  pour  warm 
water  around  them,  and  bring  the  water  to  a  temperature  of  180°. 
The  kettle  is  then  covered  and  removed  from  the  stove,  wrapped  in 

«This  infomation  is  obtained  largely  from  Prof.  Plenry  D.  Fry's  monograph 
on  "  Maternity,"  Washington,  1907,  a  work  which  can  be  confidently  recom- 
mended. 


REPORTS   OF    THE  PRESIDENT'S   HOMES   COMMISSION.  199 

a  piece  of  flannel  blanket,  and  set  upon  folded  newspapers.  At  the 
expiration  of  half  an  hour  the  bottles  should  be  taken  out,  cooled, 
and  kept  on  ice  until  used.  When  it  is  time  to  feed  the  baby,  one  of 
the  bottles  is  removed  and  set  in  hot  water  until  the  temperature 
of  the  milk  is  98°.  A  higher  or  lower  temperature  is  absolutely  in- 
jurious to  the  infant. 

QUANTITY   OF   FOOD   FOR   EACH   FEEDING. 

The  number  of  feedings  in  twenty-four  hours  has  been  given  on 
page  190.  Doctor  Fry  believes  that  a  frequent  cause  of  failure  to 
jraise  babies  on  modified  milk  is  that  they  are  overfed.  He  considers 
1  to  2  tablespoonfuls  sufficient  for  each  feeding  during  the  first  few 
weeks  of  life.  At  1  month  of  age  give  2  to  3  tablespoonfuls ;  at  G 
weeks  3  to  4  tablespoonfuls;  at  2  months  4  to  5  tablespoonfuls.  In- 
crease the  quantity  at  the  rate  of  1  ounce  each  month  up  to  6  months 
of  age.  Two  tablespoonfuls  make  an  ounce.  Another  trouble  is  the 
baby  gets  the  food  into  its  stomach  too  fast.  When  nursing  at  the 
breast  the  baby  requires  from  fifteen  to  twenty  minutes  to  suck  the 
nourishment.  When  fed  with  the  bottle  it  often  obtains  its  food  in 
five  minutes. 

In  this  connection  it  should  be  remembered  that  no  substitute  for 
human  milk  as  yet  prepared  can  take  the  place  of  a  sound  mother's 
milk,  and  that  as  long  as  we  are  compelled  to  resort  to  infant  feeding 
we  should  feel  our  way  gradually,  bearing  in  mind  Biedert's  conclu- 
sions, that  a  bottle-fed  infant  thrives  best  when  the  minimum  amount 
of  food  necessary  for  development  is  given.  If  in  the  course  of  feed- 
ing symptoms  of  diarrhea  with  green  stools  appear,  it  is  best  to  stop 
the  milk  altogether  and  feed  the  baby  with  albumen  water,  barley 
water,  or  rice  water,  and  consult  a  physician  at  once. 

Barley  water  is  made  as  follows:  Take  2  tablespoonfuls  of  pearl 
barley,  add  1  quart  of  water,  boil  for  three  hours,  add  enough  water 
to  keep  the  quantity  to  1  quart,  strain  through  course  muslin.  Keep 
well  covered  in  refrigerator,  warm  to  98°  before  using  it.  Rice 
water  is  made  in  the  same  manner. 

CARE    OF    THE    NURSERY    REFRIGERATOR,    NURSING   BOTTLES,    NIPPLES, 

UTENSILS,    ETC. 

"  It  is  absolutely  essential  that  intelligent  and  careful  attention 
should  be  paid  at  home  to  the  cleanliness  of  bottles,  nipples,  dippers, 
cooking  utensils,  etc.  The  nursery  refrigerator  must  be  metal  lined 
and  kept  clean,  aired  free  from  odors,  and  well  supplied  with  ice 
(unless  the  place  in  which  it  is  kept  has  a  temperature  less  than  50°). 

The  bottles  can  be  cleaned  as  follows:  Einse  with  the  brush  in 
cold  water  in  which  a  little  washing  soda  is  dissolved,  then  wash  and 
brush  thoroughly  with  soap  and  hot  water  and  rinse  again  in  sterile 
water.  Or  the  bottles  as  soon  as  emptied  can  be  filled  with  cold 
water  to  which  a  little  bicarbonate  of  soda  is  added.  Before  being 
refilled  they  should  be  thoroughly  washed  with  a  brush  and  hot  soap 
suds  and  then  boiled  for  twenty  minutes.  *  *  *  Never  let  a 
nursery  bottle  stay  dirty  after  use  until  the  milk  dries  in  it.  The 
neck  of  the  bottle  should  be  large  enough  to  permit  easy  cleaning 
and  it  should  have  no  corners  or  angles  on  the  inside.    The  nipples 


200  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

should  be  of  rubber  and  made  so  that  they  can  be  easily  turned  inside 
out  for  cleaning.  New  nipples  should  always  be  boiled  before  use. 
Immediately  after  use  the  nipples  should  be  washed  in  soda  water 
and  kept  in  a  solution  of  boric  acid,  and  when  wanted  again  they 
should  be  rinsed  in  water.  Attention  to  these  details  should  not  be 
neglected,  as  the  life  of  the  infant  depends  upon  absolute  cleanliness 
of  the  food  at  all  times,  and  especially  during  the  warm  months." 
From  what  has  been  said  on  this  subject  it  is  evident — 

1.  That  no  effort  should  be  spared  to  secure  the  enactment  of  more 
stringent  laws  regulating  the  production  and  sale  of  pure  milk  and 
cream. 

2.  The  establishment  of  day  nurseries,  where  the  infants  of  thosa 
who  are  obliged  to  go  out  to  their  work  may  be  properly  cared  for,  is 
urgently  called  for. 

3.  The  establishment  of  dispensaries,  where  intelligent  instructions 
are  given  in  infant  feeding  and  modified  milk  sold  at  reasonable 
rates,  would  be  in  the  interest  of  public  health  and  humanity. 

It  is  gratifying  to  note  that  such  a  dispensary  was  started  April  13, 
1908,  in  connection  with  the  Neighborhood  House  in  southwest  Wash- 
ington. According  to  Dr.  William  J.  French,  up  to  October  1,  1908, 
261  infants  and  children  have  been  treated.  There  were  but  3  deaths. 
The  records  of  the  health  office  show  that  during  1907  there  were  50 
deaths  in  southwest  Washington  in  children  under  10  years  of  age, 
while  during  the  year  1908  there  were  but  29  deaths  in  children  of 
the  same  age  period,  in  spite  of  the  very  hot  summer.  Doctor  French 
very  justly  considers  the  clean,  pure  milk  and  the  instruction  fur- 
nished by  the  dispensary  factors  in  this  marked  reduction  of  mor- 
tality rates. 

Chapter  V. 

THE    PREVENTION   OF   PERMANENT   DISABILITIES    IN   CHILDHOOD. 

The  writer,  in  his  sociological  studies  of  physically  defective  per- 
sons who  contribute  such  a  large  contingent  to  our  charitable  institu- 
tions, has  felt  convinced  that  many  of  these  partial  and  complete  dis- 
abilities could  have  been  prevented  by  proper  care  and  treatment  in 
childhood.  It  is  now  well  known  that  many  of  the  joint  deformities 
in  children  are  amenable  to  treatment,  and  that  a  ruptured  child  or 
person  may  be  radically  cured.  As  a  member  of  the  Board  of  Chari- 
ties he  recommended  that  the  physicians  to  the  poor  and  agents  of 
the  Associated  Charities  be  requested  to  encourage  the  parents  of  such 
children  to  authorize  operative  procedures  or  hospital  treatment,  for 
the  prevention  of  permanent  disabilities.  The  result  within  the  past 
year  more  than  justifies  a  general  acceptance  of  these  principles.  The 
records  of  the  Children's  Hospital  reveal  the  gratifying  fact  that  the 
operations  for  the  radical  cure  of  hernia,  for  example,  have  increased 
from  9  in  1907  to  25  in  1908,  and  that  every  child  was  discharged  as 
cured.  The  increase  in  the  number  of  joint  cases  and  deformities 
treated  is  also  very  marked. 

In  order  to  determine  the  number  of  physically  defective  children 
in  our  graded  public  schools  the  health  officer  and  the  board  of  educa- 
tion authorized  a  general  medical  survey  of  the  pupils.     The  exami- 


EEPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  201 

nation  was  conducted  by  the  medical  inspectors  of  the  schools,  under 
the  general  direction  of  Dr.  Henry  C.  Macatee,  assistant  secretary  of 
the  President's  Homes  Commission.  The  results  have  been  tabulated 
by  him  and  will  be  found  in  Table  A. 

From  this  table  we  learn  that  out  of  43,005  pupils  in  the  graded 
schools  13,407  were  colored  and  29,598  were  white.  Among  the 
colored  children  3,784  instances  of  the  defects  listed  in  the  table  were 
encountered,  or  a  relation  of  28.2  per  cent;  among  the  white  pupils 
11,520  notations  of  defects,  a  relation  of  38.9  per  cent  to  the  whole, 
were  encountered.  The  difference  in  percentage  of  defects  between 
white  and  colored  children  is  solely  due  to  better  condition  of  the 
teeth  in  the  colored  children.  Total  defects  noted,  15,304,  or  35.5 
per  cent  of  the  pupils  examined.  These  percentages,  high  as  they 
may  appear,  are  very  much  lower  than  the  rates  reported  from  New 
York. 

Omitting  from  this  consideration  the  6,698  pupils  who  probably 
needed  only  dental  care — a  matter  of  importance,  however,  to  the 
general  health — we  still  have  to  deal  with  8,606  pupils,  or  20  per  cent 
of  the  total,  whose  physical  condition  should  be  a  matter  of  grave 
concern  to  the  parents.  Of  this  number  149  were  crippled,  272  de- 
formed, 461  had  strabismus  (squint),  312  had  discharging  ears, 
835  defective  hearing,  2,176  defective  vision,  2,062  were  "mouth 
breathers,"  703  were  undersized,  727  ill  nourished,  and  934  were 
anaemic. 

It  was  not  deemed  best  to  conduct  physical  examinations  involving 
the  removal  of  clothing,  and  hence  the  number  of  ruptured  children 
,could  not  be  determined,  but,  judging  from  the  reports  of  the  agents 
of  the  Associated  Charities,  the  number  is  sufficiently  great  for  serious 
consideration. 

It  will  be  readily  conceded  that  every  crippled  or  deformed  child 
should,  if  possible,  be  spared  from  permanent  disability,  and  no 
thoughtful  parent  should  hesitate  to  act  when  attention  is  directed  to 
the  serious  consequences  of  neglect.  Poverty  is  no  excuse  for  the 
"  do-nothing  system,"  as  the  medical  charities  offer  adequate  facilities 
for  treatment  of  persons  unable  to  pay  for  the  same. 

Nor  is  there  an  excuse  for  not  attempting  to  cure  discharging  ears, 
defective  hearing  or  vision,  since  every  observer  is  familiar  with  the 
sad  consequences  of  such  defects  in  the  ultimate  struggle  for  existence. 
Parents  may  not  know  that  a  child  afflicted  with  a  squint,  harelip,  or 
cleft  palate  may  be  transformed  into  a  vicious  character,  because  it  is 
the  object  of  constant  ridicule  within  and  without  school,  and  that 
all  of  this  could  be  avoided  by  a  timely  operation.  Parents  are  prob- 
ably not  aware  that  many  of  the  nervous  affections  and  even  mental 
defects  in  boys  are  due  to  some  slight  malformation  of  the  genital 
organs,  for  which  the  Hebrews  instituted  circumcision.  Nor  is  it 
generally  known  that  anaemic  and  ill-nourished  children  and  those 
suffering  from  enlarged  tonsils,  cervical  glands,  or  post-nasal  growths, 
and  the  majorit}^  of  "  mouth  breathers  "  are  peculiarly  susceptible  to 
disease  in  general  and  to  tuberculosis  in  particular. 

Lastly,  there  is  no  good  reason  why  special  attention  should  not  be 
given  to  the  physical  development  of  undersized  children  or  those 
affected  with  slight  muscular  deformities,  which,  if  left  uncorrected, 
will  be  a  source  of  regret  and  even  reproach  to  the  teacher  and  parent. 

The  remedy  lies  chiefly  in  education,  and  for  this  purpose  the  study 


202 


EEPORTS   OF   THE   PRESIDENT  S   HOMES   COMMISSION. 


of  hygiene  should  be  made  an  important  part  of  the  school  curric- 
ulum. In  this  way  the  parents  may  be  reached  through  the  child. 
Instructive  visiting  nurses  should  be  appointed  for  the  schools,  so  that 
they  may  follow  the  child  to  the  home  and  point  out  to  the  parents  the 
desirability  of  securing  prompt  professional  advice  in  all  cases  where 
it  is  indicated,  and  especially  in  instances  where  neglect  is  likely  to 
result  in  permanent  disability.  In  this  general  educational  campaign 
the  medical  inspectors  of  schools,  teachers,  social-settlement  workers, 
agents,  and  friendly  visitors  of  the  Associated  Charities  can  render  a 
distinct  service  to  the  child  and  the  State. 


Table  A. — Inquiry  for  the  PresidenVs  Homes  Commission — Medical  inspection 
of  puUic  school  children,  Washington,  D.  C. 


School 

d 

a 

i 

5 

0 

1 
5 

t 

1 

•d 

1 

0 

3 
'> 

a> 
> 

u 
<u 
"S 
0 

bo 

a 

xi  - 
Q 

B 

Xi 

5 

B  ^ 

Si 

1 

1 

1 
g 

1 

WHITE. 

Corcoran                .  . 

39 
29 

11 
13 

2 
28 
24 
11 

9 
14 

I 

3 

8 

9 

7 

11 

13 

2 

16 

4 

7 

2 

17 
8 

1 

31 
12 

6 
6 

•    9 
1 

3 
2 

10 
5 

1 
1 

39 
22 

13 
6 

3 

6 

2 

2 

1 

86 
53 

27 

23 

12 

73 

76 

56 

20 

72 

104 

5 

5 

78 

105 

19 

65 

3 

18 

9 

109 

83 

13 

62 

36 

71 

41 

95 

69 

25 

40 

14 

42 

42 

62 

52 

18 

72 

80 

41 

87 

143 

47 

104 

98 

166 

102 

103 

104 

110 

68 

91 

226 
139 

68 

63 

14 
159 
187 
116 

67 
117 
155 

27 

23 
154 
202 

70 
113 

45 

69 

68 
156 
121 

31 
122 

91 
120 

82 
191 
173 
101 
124 

73 
114 
139 
166 
108 

37 
135 
169 

85 
156 
251 

93 
192 
191 
345 
246 
207 
198 
276 
137 
182 

412 

■Wpi  or  Vi  t.m  fl  n 

375 

Industrial      Home 
School 

.... 

3 

134 

127 

Conduit                   .... 

24 

3 
1 

2 

"2 

1 
5 
1 
1 

1 
2 

6 
6 
4 

1 
1 
1 
7 
2 
1 

15 

19 

18 

14 

19 

20 

1 

3 

17 

6 

5 

5 

4 

7 

7 

6 

4 

2 

4 

14 

18 

16 

43 

23 

15 

43 

37 

20 

21 

27 

21 

15 

33 

45 

16 

32 

48 

25 

31 

81 

56 

40 

36 

38 

89 

13 

22 

5 

5 
5 
1 
3 
3 
1 
...... 

2 

'.'J. 

2 

I 

1 

2 

3 



'""i* 

2 

....„ 

2 

8 
7 
3 

6 
4 
4 
1 
1 
2 
4 
8 
1 
2 
4 
2 
1 
4 
...... 

9 
13 

il 

12 
16 
13 

16 
28 
10 
13 
2 
7 
6 
9 
25 
46 
20 
21 
8 
15 
13 
14 
14 
10 
15 
17 
12 
10 
27 
41 
18 
20 
13 
36 
83 
26 
14 
2 
12 
24 
23 
20 
25 
8 
27 
30 
56 
47 
25 
37 
37 
17 
12 

4 
13 
5 

1 
1 
3 

1 

""2 

1 
5 

278 

Curtis                

369 

Addison 

319 

Hyde     

341 

Fillmore 

272 

313 

114 

Beiinintr 

127 

Edmonds 

2 

1 
2 

.... 

13 
19 
7 
7 
9 
9 
8 
5 
2 
5 
10 
6 
2 
4 
4 
12 
16 
3 
3 
11 
8 
17 
4 
1 
6 
9 
1 

12 
16 
6 
7 

19 

22 

26 

7 

9 

10 

8 

12 

6 
10 

1 
3 
1 
3 
2 

'I 

"'il' 
...... 

:::::: 

I 

3 
...... 

6 

1 

2 

6 

4 

3 

7 

16 

11 

5 

6 

8 

7 

14 

377 

Tavlor 

323 

Maury 

1 

369 

312 

Blair 

2 
10 
5 
2 
2 

329 

Blow 

1 
4 

1 

.... 

206 

Webb 

383 

305 

Pierce 

367 

Kenil  worth 

101 

Wheatley 

10 
3 

"2 
1 

1 
3 
3 
2 

1 
"3' 

"i' 

2 

1 

2 

1 

...... 

2 
4 
2 

359 

Eckington 

340 

414 

Langdon  

275 

1 
3 
3 
3 

1 

621 

Abbot 

399 

Twining 

312 

468 

2 

3 

1 

""e 

1 

501 

Polk 

....„ 

2 

2 

1 
16 
20 
11 

413 

Morse 

i 

2 
2 

1 

1 

334 

Seaton  1 

407 

Haves 

.... 
3 

1 

299 

Stanton 

142 

Van  Ness,  J.  P 

.... 

1 

5 
4 
1 

;;:;:; 

318 

Ketehem 

1 
2 

301 

Van  Buren 

76 

Van  Buren  Annex 

3 
4 

326 

Bradley  

4 
1 
8 
3 

23 
5 

19 

il 

11 
8 

6 
2 
5 



376 

Potomac 

138 

Small  wood 

2 

"2 
3 

1 

1 
2 
1 

1 
2 

4 

1 

...... 

3 

400 

Amidon 

405 

3 
7 
6 
3 
19 
5 
7 

1 
1 

j- 

3 
2 

810 

Bowen.S.J 

Greenleaf 

352 
391 

Congress  Heights 

847 

Cranch 

Tvler 

Buchanan 

7 
3 

4 

4 

1 
1 

8 
1 
9 

602 
386 
414 

KEPOKTS    OF   THE  PKESIDENT  S   HOMES   COMMISSION. 


203 


Table  A. — Inquiry  for  the  PresidenVs  Homes  Commission — Medical  inspection 
of  public  school  children,  Washington,  D.  C. — Continued. 


School. 

< 

ft 

o 

1 

1 

i 
1 

+3 

03 

1 

s 

It 

WHITE— con. 
Orr                      

8 
14 
16 
19 

18 
19 
26 
18 
17 

1 

3 
2 
2 
1 
2 
2 
1 
- 

2 

■"--- 

4 
6 

8 

I 

4 
5 
5 
10 

18 
29 
39 
21 
54 
35 
40 
18 
56 

3 
21 
25 
40 
31 
35 
24 
18 
30 
30 
14 
18 

3 
13 

6 
11 

3 
18 
14 
37 
39 
44 
12 
12 
19 
18 

1 

1 
5 
6 
6 

11 
9 

10 
7 
2 

5 
4 
3 
6 
10 
11 
13 
13 
10 

8 
29 
30 
40 
44 
31 
37 
25 
14 

5 

18 
9 
28 
19 
16 
20 
8 
4 
5 
15 
12 
4 
13 
5 
4 
1 
2 
4 
1 
2 
2 
2 
5 
2 
3 
2 
3 
5 
6 
5 
14 

"2 

4 

2 
6 
5 
8 
1 

27 
6 
1 

10 

2 

...... 

1 

3 

...... 

...... 

3 

'""i" 

....„ 
....„ 
....„ 

...... 

1 

33 
130 
154 
30 
72 
190 
144 
81 
96 
6 
3 
10 
53 
57 
64 
60 
52 
66 
88 
19 
49 
107 
78 
72 
67 
18 
90 
42 
97 
135 
112 
25 

■■■33" 
52 

85 

245 
273 
156 
236 
364 
304 
178 
220 
17 
70 
91 
93 
138 
130 
105 
88 
111 
144 
43 
77 
120 
105 
99 
88 
29 
135 
74 
167 
193 
189 
103 
21 
69 

202 

376 

Dent                

380 

Brent 

319 

Wallach      

591 

Towers                  

424 

Peabody 

588 

Hilton              

376 

Carbery 

335 

306 

Force                        

4 
3 

2 
1 
5 
3 
2 
4 
8 

.'.'.. 

1 
2 

I 

5 

6 



4 
2 
4 
1 
4 
6 
3 
1 
....„ 

1 
1 
2 
2 



3 
4 
6 
1 
6 
3 
7 
1 
2 
1 
1 

""2 

1 
1 

17 
28 
7 
18 
5 
3 
4 
6 
8 
4 
2 
5 
2 
8 
2 
3 
6 
3 
7 
4 
14 
28 
3 
1 
4 

1 

603 

Webster 

554 

Grant             

456 

Gales 

425 

Arthur     

345 

Toner                       

296 

Blake  

294 

Hubbard                  

363 

Petworth                 

3 

347 

107 

Takoma «                 

4 

1 

2 

3 

2 

1 

7 

8 

13 

4 

10 

12 

273 

Morgan,  T.  P  

1 

...... 

"""i' 
1 

3 
3 
1 

469 

Harrison                 

304 

424 

330 

Woodburn 

108 

Phelps,  1     

4 

3 
2 
4 

.'.1 



3 

1 
2 
2 
2 
6 
2 
1 
5 

1 

349 

Brentwood 

194 

Monroe 

359 

Johnson     

525 

Ross 

478 

Franklin 

1 
1 

357 

625  Q  street,  Atypical-. 
Chevy  Chase 

1 
2 
2 

1 

36 

244 

Berret 

2 

1 

249 

Twelfth  Street  Kinder- 
garten  



1 

31 

Total  (miscella- 
neous, 2) 

555 

99 

59 

217 

1,898 

251 

375 

1,492 

656 

261 

5,574 

11,520 

29,598 

COLORED. 

Magruder..             

5 
29 
10 
10 
13 

10 
1 
1 

1 

1 

14 
2 
13 
7 
8 
29 
12 
10 
3 
1 
16 
5 

3 

4 

14 

24 

33 

12 

29 

13 

9 

5 

1 

26 

9 

1 

4 
3 
7 
5 
5 
1 
9 
2 
6 

2 

7 

8 
32 
41 

4 
14 

7 
17 

2 

5 
17 
19 

8 
22 

4 
12 

8 
19 

4 

1 
26 

1 

19 
26 
16 
20 
27 
6 
15 
18 
27 
8 
1 
14 
10 
4 
9 

10 
11 
17 
22 
50 
17 
9 
48 
39 
14 
26 

7 
6 
5 
7 
5 
1 
3 

1 
4 

""2 
1 
3 

18 

24 
18 
50 
57 
43 
78 

2 
20 
15 

7 
41 

8 

75 
137 
100 
172 
■  211 

82 
190 

66 
111 

37 

12 
141 

41 

286 

Slater 

360 

Langston 

252 

Douglass 

374 

458 

Ivy  Citv              

123 

Ab.  Simmons 

I 

1 

-   - 

317 

Jones 

276 

Logan 

2 

365 

Deanwood 

230 

BenningRoad 

1 
3 
2 

106 

Payne 

3 
2 
2 
5 
3 
5 
3 

14 
5 
6 
2 
6 
8 
2 
1 

10 

2 

322 

WUson,  Hy 



358 

Chain  Bridge 

31 

Reno 

1 
1 
3 

"'i' 

3 

"2 
2 

3 
3 
4 
1 
6 
4 
6 
2 
16 
12 
4 
1 

...... 

2 

"ii" 
1 

2 

29 
12 
5 
6 
17 
43 
11 
12 
76 
73 
56 
64 

47 
33 
33 

72 
85 
158 
74 
52 
190 
181 
117 
128 

145 

Sumner 

2 
1 
4 
9 
12 
6 
4 

'"'i' 

2 
3 
5 

I 

7 
6 
12 
14 
20 
14 

192 

Miner 

.. 

"2 

2 
9 
7 
3 
5 
7 
1 
8 

1 
29 

5 
17 
13 
11 
15 

6 

7 
11 

368 

Montgomery 

5 

6 

8 

1 

3 

12 

10 

10 

9 

334 

Briggs 

394 

Stevens 

800 

Phillips 

337 

Wormley 

358 

A.  Lincoln 

360 

BeU 

367 

Giddings 

347 

Randall 

463 

•  Takoma  first  grade  not  included. 


204 


EEPORTS   OF   THE   PRESIDENT  S   HOMES   COMMISSION. 


Table  A. — Inquiry  for  the  President's  Homes  Commission — Medical  inspection 
of  puhlic  school  children,  Washington,  D.  C. — Continued. 


School. 

d 
•< 

1 
5 

s 

t5 

1 

1 

5 

1 

a 
0 
.£2 

t 

1 

0 

g 
1 

1 

1 
1 

be 

1 

i 

ii 

5 

5 

ii 

B 
0 

4i 

1 
g 

1 

COLORED— cont'd. 
A.  Bowen 

9 

7 
12 

8 
21 
13 
10 
12 

9 

5 
10 
19 

2 

1 
1 
2 

1 

3 

? 

3 

8 
10 
14 
15 
14 
25 
19 
23 
17 

9 
34 

6 

4 
9 
3 
3 
9 
7 
4 
6 
2 
2 
2 
1 

2 

1 

....„ 

2 
4 
3 

10 
13 
21 
10 
15 
5 

3 

18 

49 

33 

29 

8 

13 

8 

8 

9 

1 

5 

12 

3 

1 

3 

5 

16 

14 

11 

12 

4 

2 

4 

3 

1 

2 

6 

2 
6 
2 
2 
2 
1 
1 





....„ 

55 

61 

75 

60 

67 

3 

6 

9 

2 

2 

I 

1 

118 

176 

174 

145 

158 

70 

67 

61 

58 

34 

38 

83 

14 

5 

18 

6 

6 

297 

Bimey 

470 

Ambush .   . 

320 

Cardoza        

"2" 
2 

"3" 
1 

! 

1 
.... 

1 

5 
7 
3 
3 
2 
4 
2 
1 
2 
1 
1 
1 
2 
1 

404 

Syphax 

343 

Garnet 

694 

Mott.         .  . 

523 

Banneker 

385 

Cook 

1 

1 

....„ 

2 
2 
2 
6 

369 

Bruce 

222 

Garrison 

423 

Patterson 

497 

Military  Road 

96 

Fort  Slocum 

1 
2 

1 
4 

51 

Orphans'  Home 

Garnet  Atypical 

3 

1 
1 

1 
1 

1 

1 

1 



73 
13 

St.  Luke  Atypical 

1 

14 

Total 

279 

50 

213 

510 

164 

210 

328 

684 

179 

51 

1,124 

3,784 

13, 407 

Grand  total 

934 

149 

272 

727 

2,062 

461 

703 

2,176 

835 

312 

6,698 

15,304 

43,005 

Per  cent   relation   to 
total  examined: 
White 

2.21 
2.08 
2.17 

0.33 
.37 

0.19 
1.58 
.63 

0.73 
3.80 
1.69 

6.41 
1.22 
4.79 

0.84 
1.56 
1.07 

1.26 
2.44 
1.63 

5.04 
5.10 
5.05 

2.21 
,1.33 
•1.94 

0.88 

18.83 
8.38 
15.57 

Colored 

All 

Defects,  exclusive  of  toothache,  occurred  In—  Per  cent. 

White 20.08 

Colored 19.84 

All 20.01 

All  defects  occurred  in- 
White 38.92 

Colored 28.22 

All 35.58 


,  Chapter  VI. 

THE  HEALTH  OF  THE  CITY   OF  WASHINGTON. 

In  speaking  of  the  health  of  a  given  locality  it  has  always  been 
deemed  necessary  that  the  climatic  and  telluric  conditions  should  be 
considered.  For  the  purpose  of  a  comparative  study  I  requested 
Prof.  Willis  L.  Moore  and  Prof.  A.  J.  Henry,  of  the  United  States 
Weather  Bureau,  to  furnish  me  with  meteorological  data  covering  a 
period  of  thirty  years  for  the  city  of  Washington  and  six  other  cities 
where  the  climatic  conditions  are  quite  similar  to  those  which  obtain 
in  this  city.  A  careful  analysis  of  these  data  and  a  study  of  the  com- 
parative mortality  statistics  justify  the  conclusion  that  there  is  ab- 
solutely nothing  inimical  to  health  in  the  climate  of  Washington.  It 
was  found,  however,  that  although  the  city  enjoys  practically  the  same 
climate  as  Cincinnati,  Indianapolis,  Detroit,  Philadelphia,  Spring- 


REPOKTS   OP   THE  PRESIDENT'S  HOMES   COMMISSIOF.  205 

field,  and  Kansas  City,  it  has  the  highest  death  rate'' — 22.8  per  1,000 — 
Philadelphia  coming  next  with  a  rate  of  21.2  per  1,000,  while  Detroit, 
Kansas  City,  Indianapolis,  and  Springfield  have  an  average  of  17.5 
per  1,000.^' 

As  a  matter  of  record,  Doctor  Busey,  in  one  of  his  addresses,  quotes 
the  Washington  Gazette  of  1791,  that  "  during  that  year,  in  a 
population  of  2,000,  but  7  deaths  occurred  in  this  city."  If ,  then, 
during  succeeding  decades,  "  fatal  epidemics  of  bilious  fever,  inter- 
mittent bilious  fever,  and  bilious  dysentery,"  and  typhoid  fever 
occurred,  and  the  reputation  of  the  National  Capital  as  regards  health 
conditions  has  suffered,  it  can  not  be  the  effect  of  climate,  but  of  some- 
thing added  to  the  climate,  and  students  of  the  subject  have  long  since 
recognized  that,  apart  from  temperature,  humidity,  atmospheric  pres- 
sure, winds,  sunshine,  and  other  meteorological  conditions,  there  are 
many  factors — such  as  soil,  water,  impure  air,  the  presence  of  insects, 
social"  and  racial  problems — which  play  an  important  role  in  the 
healthfulness  of  a  given  locality. 

It  can  be  safely  asserted  that  a  number  of  causes  have  operated  in 
the  production  of  insanitary  factors  in  the  National  Capital. 

The  topography  of  the  basin  in  which  the  city  is  located  was  undu- 
lating, interspersed  with  small  valleys,  ravines,  morasses,  and  lowlands 
subject  to  periodical  overflows.  The  lowlands,  according  to  Doctor 
Busey,  "  spread  south  of  the  F  street  ridge  to  the  river  shore,  includ- 
ing a  greater  part  of  the  ^Vhite  Lot  and  the  Mall,  and  in  the  section 
known  as  '  the  slashes,'  lying  along  the  northern  boundary  from  the 
Tiber  to  Rock  Creek,  and  dipping  in  many  places  far  into  the  interior 
of  the  basin.  When  the  city  was  first  platted  there  were  no  Potomac 
and  Anacostia  River  flats;  the  formation  of  the  Potomac  marshes  is 
attributed  to  the  construction  of  the  Anacostia  causeway  in  1805  and 
the  building  of  the  Long  Bridge  in  1808,  and  the  Anacostia  River 
flats  to  the  construction  of  the  Kentucky  Avenue  Bridge  in  1795  and 
the  Bennings  Bridge  in  1797."  Whatever  their  cause  may  have  been, 
they  increased  from  year  to  year  by  continuous  depositions  and  soon 
became  notorious  breeding  grounds  for  mosquitoes  and  the  chief 
source  for  the  propagation  of  malaria.  The  Potomac  flats  have  been 
reclaimed  since  1882,  adding  about  621  acres  to  our  parking  system, 
but  the  Anacostia  River  flats,  which  cover  an  area  of  over  1,000  acres, 
the  title  to  which  is  vested  in  the  United  States,  still  continue  to  be  a 
menace  to  the  health  of  our  inhabitants.  The  reclamation  of  the 
Potomac  flats  has  greatly  reduced  the  prevalence  of  malaria,  as  shown 
by  the  statistics  of  the  health  department,  and  it  is  reasonably  and 
scientifically  correct  to  maintain  that  similar  results  would  follow  the 
reclamation  of  the  Anacostia  flats.  Take  away  the  mosquito-breeding 
places  of  every  description  and  there  will  ne  no  extra  corporal  habitat 
for  the  germs  of  malaria.  It  is  a  deplorable  fact  that,  although  this 
measure  has  been  urged  by  the  Commissioners  since  1894,  no  legis- 
lative action  has  yet  been  taken. 

o  Of  these  seven  cities  Washington  had  the  highest  death  rates  from  malarial 
and  diarrheal  diseases,  typhoid,  and  consumption  (Philadelphia  exceeding  in 
pneumonia ) . 

*  Considerably  less  than  the  general  death  rate  in  the  registration  area  in  the 
United  States,  representing  10,000,000  inhabitants.  For  the  census  year  1900 
this  was  18.6  per  1,000. 


206  KEPOKTS   OF   THE   PRESIDENT'S   HOMES   COMMISSION. 

RELATIONS  OF  WATER  SUPPLY  AND  SEWERS  TO  HEALTH, 

Prior  to  the  introduction  of  Potomac  water  in  1859  the  inhabitants 
had  to  depend  upon  springs,  pumps,  wells,  and  cisterns  subject  to  pol- 
lution from  sewage  of  cesspools,  vaults,  and  box  privies.  It  was 
the  old  story  of  wells  and  privies  being  dangerous  neighbors  and 
failure  to  recognize  the  necessity  that  a  system  of  public  sewerage 
must  go  hand  in  hand  with  the  public  water  supply,  the  neglect  of 
which  compels  recourse  to  various  makeshifts,  and  must  inevitably 
lead  to  pollution  of  soil,  water,  and  air.  There  can  be  no  question 
that  these  factors  have  played  an  important  role  in  the  causation  and 
spread  of  typhoid  fever,  dysentery,  diarrhea,  and  other  intestinal 
infections,  and  have  served  to  swell  the  general  mortality  rates. 
Many  of  these  conditions  have  been  improved,  a  comprehensive  sys- 
tem of  sewerage  disposal  has  been  adopted  within  the  city  limits, 
and  the  number  of  public  pumps  has  been  reduced  from  171  iii  1895 
to  42  in  1908.  The  number  of  private  wells,  however,  is  a  matter  of 
conjecture. 

It  may  be  urged  that  with  the  introduction  of  a  purer  water  supply 
in  1859,  health  conditions,  especially  as  regards  the  so-called  "  water- 
borne  diseases,"  should  have  improved,  but  it  is  a  long  and  tedious 
matter  to  convince  the  average  man  that  a  clear,  sparkling  and  very 
palatable  pump  water  in  cities  may  be,  and  very  frequently  is,  liable  to 
the  grossest  forms  of  pollution.  He  knows  from  observation  that 
hydrant  water  is  at  times  absolutely  j&lthy  from  suspended  matter, 
and  that  it  reaches  in  summer  a  temperature  which  is  far  from  palata- 
ble. But  he  does  not  know  that  the  well  water  in  its  passage  may 
have  simply  been  deprived  of  the  suspended  matter,  without  losing 
some  of  the  most  dangerous  forms  of  disease  germs.  It  involves, 
therefore,  many  years  of  education  to  impress  the  public  with  the 
dangers  of  pumps,  and,  by  the  time  this  was  fairly  well  accomplished 
(although  many  even  now  are  still  in  doubt)  the  Potomac  River,  by 
reason  of  an  ever-increasing  population  in  the  towns,  villages,  and 
settlements  located  along  the  banks  and  within  its  watershed,  had  be- 
come itself  a  dangerous  source  of  infection. 

My  suspicions  that  typhoid- fever  germs  might  travel  all  the  way 
from  Cumberland,  a  distance  of  134  miles,  and  infect  the  consumers 
of  Potomac  water  in  Washington,  were  confirmed  as  early  as  the 
winter  of  1889-90  by  studying  the  effects  of  the  typhoid-fever  epi- 
demic at  Cumberland  upon  the  prevalence  of  the  disease  in  Washing- 
ton. The  records  of  the  health  office  show  that  during  this  epidemic, 
from  December,  1889,  to  April,  1890,  the  deaths  from  typhoid  fever 
amounted  to  74,  as  compared  with  42  for  the  corresponding  months 
of  the  previous  year.  Indeed,  we  had  almost  double  the  number  of 
typhoid  deaths  during  these  months  than  for  any  correspond i no- 
months  either  before  or  since  this  epidemic.  Cumberland  had  about 
45  deaths  and  485  cases.  Washington  had  74  deaths  and  about  800 
cases,  and  yet  the  starting  point  of  all  was  the  excreta  of  one  patient 
washed  into  a  little  run  which  empties  into  the  Potomac  River  300 
feet  above  the  pumping  station  of  the  water  supply  for  Cumberland. 
In  the  face  of  this  fact  and  the  almost  constant  presence  of  intesti- 
nal bacteria  in  Potomac  water,  the  writer  had  no  hesitation  in  de- 
claring that  the  excessive  typhoid-fever  rate  of  the  National  Capital 


BEPOKTS    OF    THE  PRESIDENT'S  HOMES   COMMISSION.  207 

was  largely  due  to  contaminated  Potomac  water,  and  urged,  with 
other  members  of  the  profession,  the  speedy  purification  by  means  of 
sand  filtration,  as  well  as  the  prevention  of  river  pollution. 

FILTRATION  OF  THE  POTOMAC  WATER. 

In  1901  and  subsequent  thereto  Congress  appropriated  sufficient 
money  for  a  complete  system  of  slow  or  natural  sand  filters.  This 
filtration  plant  was  completed  under  the  supervision  of  United  States 
engineer  officers,  with  Allen  Hazen  as  consulting  engineer,  in  the  fall 
of  1905.  It  covers  29  acres  and  is  the  largest  in  America,  and  in  many 
respects  the  most  modern  and  scientific  in  the  world.  It  handles 
about  75,000,000  gallons  a  day  and  eliminates  98  to  99  per  cent  of  all 
the  bacteria;  and  we  have  at  least  the  comforting  assurance  that  a 
corresponding  percentage  of  disease-producing  germs  will  also  be 
removed.  The  effects  of  filtration  upon  the  typhoid  fever  rates  are 
shown  by  the  fact  that  the  rate  reached  as  high  as  104  in  1890,  and 
was  still  60.3  during  the  five-vear  period  1896-1900,  but  has  fallen  in 
1907  to  34.6  per  100,000.  As^a  result  of  the  installation  of  filtration 
plants  elsewhere,  not  only  a  reduction  of  81  per  cent  in  the  deaths 
from  typhoid  fever  has  been  noted,  but  also  a  marked  reduction  in 
the  general  death  rate.  Computations  by  Hazen  clearly  indicate  that 
where  one  death  from  typhoid  fever  has  been  avoided  by  the  use  of  a 
better  water,  a  certain  number  of  deaths,  probably  two  or  three,  from 
other  causes,  have  been  avoided. 

It  is  a  difficult  matter  to  explain  how  water  is  connected  with  the 
deaths  other  than  those  from  water-borne  diseases,  yet  when  we  con- 
sider that  water  enters  into  the  composition  of  the  body  to  the  extent 
of  about  60  per  cent,  we  are  in  a  position  to  appreciate  the  sanitary 
acumen  of  Aristotle  when  he  wrote  in  his  Politica : 

The  greatest  influence  upon  health  is  exerted  upon  those  things  which  we  most 
freely  and  frequently  require  for  our  existence,  and  this  is  especially  true  of 
water  and  air. 

INFLUENCE  OF   SEWERS   UPON   THE   HEALTH   OF   THE   COMMUNITY. 

According  to  D.  C.  McComb,  superintendent  of  sewers,  "  the  first 
action  materially  affecting  the  drainage  of  the  city  was  the  con- 
struction of  the  Washington  Canal,  from  the  Potomac  River  at  the 
foot  of  Seventeenth  street  west  to  the  Anacostia  River  at  the  foot  of 
Second  street  east.  The  sewers  constructed  by  the  city  prior  to  1871 
emptied  into  the  canal.  *  *  *  After  the  introduction  of  the 
Potomac  water  supply  in  the  year  1859  the  demand  for  and  the  con- 
struction of  sewers  increased,  and  it  was  not  long  before  complaints 
were  made  of  the  nuisance  caused  by  the  foul  materials  brought  by 
these  sewers  to  the  canal.  *  *  *  j^  ^j^^  ^^^  until  the  act  of  the 
legislative  assembly  of  August  21,  1871,  that  the  discharge  of  solids 
into  sewers  was  permitted,  although  in  point  of  fact  water-closets 
with  direct  sewer  connections  were  in  use  for  many  years  prior  to  the 
passage  of  this  act." 

As  a  result  of  these  conditions,  the  board  of  health,  in  1871,  found 
not  only  over  30,000  privy  boxes,  "  many  in  bad  condition  and  over- 
flowing," the  contents  of  which  were  emptied,  according  to  Doctor 


208  REPORTS  OF  THE  PRESIDENT'S  HOMES  COMMISSION. 

Tindall,  upon  the  commons  of  south  Washington,  within  less  than  1 
mile  from  the  best  residence  and  business  section  of  the  city,  but  also 
that  the  Washington  Canal,  which  L'Enfant  had  hoped  to  preserve 
as  a  natural  waterway,  had  become,  in  the  language  of  Professor 
Henry,  of  the  Smithsonian  Institution,  "  an  open  cesspool,  a  fruitful 
source  of  discomfort  and  disease,  receiving  the  sewage  direct  in  its 
midst,  and  inconsistent  with  the  intelligence  of  the  age."  This  great 
nuisance,  passing  within  a  few  hundred  yards  of  the  White  House,  the 
War,  Navy,  and  State  Departments,  through  the  Agricultural,  Smith- 
sonian, and  Botanical  gardens,  almost  to  the  very  gates  of  the  Capitol, 
was  abated  in  1871-1880,  upon  the  demands  of  the  board  of  health. 

It  is  safe  to  say  that  the  District  prior  to  1871  spent  less  than 
$100,000  for  sewers.  We  now  have  103.2  miles  of  main  sewers  and 
365.2  miles  of  pipe  sewers,  constructed  at  a  total  cost  of  $13,613,932.38. 
Provisions  have  never  been  adequate,  however,  and  the  records  of  the 
health  department  show  that  even  now  in  about  4,100  houses  sewer 
connections  can  not  be  made  because  of  the  absence  of  branch  sewers. 

A  summary  of  the  evidence  reveals  the  significant  fact  that  the 
cities,  both  at  home  and  abroad,  in  which  there  has  been  the  most 
marked  decrease  in  typhoid  fever  are  those  in  which  a  pure  water 
supply  has  been  substituted  for  a  preexisting  contaminated  one,  and 
the  effects  are  still  more  marked  when  combined  with  a  good  sewerage 
system. 

The  history  of  every  sewered  town  shows  a  lessening  of  the  typhoid 
death  rate  subsequent  to  the  construction  of  the  sewers,  and  that  the 
typhoid  rate  is  always  higher  in  sections  supplied  with  makeshifts. 
In  1895  the  writer  pointed  out  that  typhoid  prevailed  in  the  city  of 
Washington  in  1  of  81  houses  with  privies  and  in  only  1  in  149 
of  those  connected  with  sewers.  The  health  officer  of  Nottingham, 
England,  has  since  then  presented  similar  evidence.  The  only  reason- 
able explanation  for  this  is  that  sewers  carry  away  the  filth  that  other- 
wise would  contaminate  the  soil  and  ground  water,  but  even  if  there 
were  no  wells  these  makeshifts  are  still  a  source  of  danger  in  so  far  as 
they  favor  the  transmission  of  the  infection  by  means  of  flies,  nor 
can  the  possibility  be  ignored  that  the  germs  in  leaky  or  overflowing 
boxes  may  reach  the  upper  layer  of  the  soil  and,  with  pulverized  dust, 
gain  access  to  the  system. 

HAS   HUMAN   LIFE  BEEN   PROLONGED  BY  EFFORTS  IN   SANITATION? 

Professor  Finkelnburg,  of  Bonn,  estimates  that  the  average  length 
of  human  life  in  the  sixteenth  century  was  only  between  eighteen  and 
twenty  years,  and  at  the  close  of  the  eighteenth  century  it  w^as  a  little 
over  thirty  years,  while  to-day  it  is  between  thirty-eight  and  forty 
years ;  indeed,  the  span  of  life  since  1880  has  been  lengthened  about 
six  years.  No  two  factors  have  contributed  so  much  to  the  general 
result  as  the  improvement  of  the  air  we  breathe  and  the  water  we 
drink.  Indeed,  we  have  ample  evidence  that,  with  the  introduction 
of  public  water  supplies  and  sewers,  the  general  mortality  in  numer- 
ous cities  during  the  past  fifty  years  has  been  reduced  fully  one-half, 
the  good  effects  being  especially  shown  by  a  marked  decrease  in  the 
number  of  cases  of  typhoid  fever,  diarrheal  diseases,  and  consump- 


KEPOBTS    OF    THE   PRESIDENT  S  HOMES   COMMISSION. 


209 


tion.  The  vital  statistics  of  Great  Britain  furnish  the  proof,"  and 
our  experience  with  American  cities  confirms  this  conclusion. 

The  death  rate  in  London  has  been  decreased  from  40  per  1,000  in 
1780  to  15.1  per  1,000  in  1905 ;  in  Berlin,  from  32.9  in  1875  to  16.4 
in  1904;  in  Munich,  from  41.6  in  1871  to  18  in  1906;  in  Washington, 
from  28.08  in  1875  to  19.25  in  1907 ;  and  in  New  York,  from  38  per 
1,000  in  1854  to  18.9  in  1906.  The  general  mortality  in  the  United 
States  has  been  reduced  from  19.6  in  1890  to  16.2  per  1,000  in  1905, 
which  means  a  saving  of  over  290,000  lives  in  one  year  alone. 

To  demonstrate  the  beneficent  effects  of  sanitary  reforms,  the  fol- 
lowing comparative  illustration,  which  I  gathered  from  one  of  the 
public  addresses  of  my  deceased  friend,  Doctor  Busey,  and  have 
brought  up  to  date,  may  be  cited : 

In  1872  the  cities  of  Berlin  and  Wasliington  were  alike  in  primitive  municipal 
methods  of  sanitation.  Without  adequate  distribution  of  the  water  supply, 
the  larger  part  of  their  population  was  dependent  upon  public  and  private 
wells.  Without  systems  of  sewerage,  both  were  alike  supplied  with  makeshifts 
for  the  disposal  of  human  excreta  and  waste  waters.  The  unpaved  streets 
were  the  common  receptacle  of  garbage,  ashes,  and  house  sweepings,  and  along 
the  gutters  the  surface  and  house  drainage  were  conducted  to  the  neighboring 
water  courses.  Since  the  city  of  Berlin  began  the  system  of  sanitary  improve- 
ments, completed  in  1890,  at  a  cost  of  59,000,000  marks  for  a  pure  and  ample 
water  supply  and  42,500,000  marks  for  construction  of  sewers,  the  typhoid 
fever  death  rate  has  fallen  from  143  in  1872  to  5  in  1896  per  100,000  of  its 
inhabitants,  and  the  general  death  rate  from  32.9  in  1875  per  1,000  to  16.4  per 
1,000  in  1904;  while  our  death  rate  from  typhoid  fever  is  still  seven  times 
greater  than  that  of  Berlin,  our  general  death  rate  has  been  reduced  from  28.08 
in  1875  to  19.25  in  1907 — results  not  so  much  due  to  climatic  differences,  but 
largely  due  to  the  fact  that  the  German  capital  enjoyed  superior  advantages  in 
sanitation  and  the  housing  problem,  while  we  are  still  in  the  process  of  evolu- 
tion, and  are  making  slower  progress  on  account  of  the  mixed  character  of 
our  population. 

The  writer,  however,  is  not  a  pessimist  as  regards  the  health  of  this 
city,  since  a  retrospect  conclusively  shows  that  the  efforts  of  Senator 
Gallinger  and  other  Members  of  Congress,  the  Commissioners,  and 
the  health  department  in  the  sanitation  of  the  national  capital  have 
been  most  fruitful  and  beneficent. 

DECREASE  IN  DEATH  RATES  SINCE  1876. 

When  we  recall  the  fact  that  in  1875  the  death  rate  for  the  white 
population  was  still  21.04  per  1,000,  while  in  1907  it  was  only  15.54, 

oThe  following  table  shows  the  death  rate  from  certain  diseases  per  10,000 
of  population  in  English  cities  before  and  after  the  introduction  of  sanitary 
works  (see  Cameron,  "A  Manual  of  Hygiene,"  1874,  p.  129)  : 


Before  sanitary  works. 

After  sanitary  works. 

City. 

Typhoid 
fever. 

Diarrhea. 

Consump- 
tion. 

Typhoid 
fever. 

Diarrhea. 

Consump- 
tion. 

Bristol 

10.0 
14.7 
17.5 
14.2 
19.0 
12.5 
13.3 

10.5 
16.0 
17.2 
11.0 
5.7 
11.2 
4.0 
9.5 
10.0 

31.0 
43.3 
34.7 
51.5 
40.0 
26.6 
25.5 
26.5 

6.5 
7.7 
10.5 
8.5 
9.0 
4.0 
5.7 
9.0 
5.5 

9.1 

19.3 
4.5 
9.0 
8.0 
5.7 
8.3 
7.0 
7.0 

25.5 
29.3 
28.6 
35.3 
32.3 
26.5 
31.3 
21.2 

Leicester 

Cardiff 

Macclesfield 

Warwick 

Stratford 

Ashby 

Dover 

14.0 
15.0 

Croydon  

S.  Doc.  644,  60-2- 


-15 


210  KEPORTS   OF   THE   PRESIDENT'S   HOMES   COMMISSION. 

and  that  likewise  a  steady  and  most  gratifying  decrease  from  42.86 
to  28.21  per  1,000  of  the  colored  population  has  taken  place,  we  have 
reason  to  look  hopefully  to  the  future. 

In  discussing  the  healthfulness  of  the  national  capital,  it  would 
not  be  just  to  the  fair  name  of  our  city  did  we  fail  to  emphasize  the 
fact  that  the  colored  element  is  a  potent  factor  in  maintaining  a  high 
general  death  rate.  For  example,  the  mortality  rate  during  the 
census  year  of  1900  in  the  larger  cities  of  the  registration  area  in 
the  United  States,  representing  10.000,000  of  inhabitants,  surrounded 
by  modern  influences  of  civilization,  was  18.6  per  1,000;  our  own 
rate  for  the  white  population  was  17.81,  and  for  the  colored  30.43, 
making  a  general  high  average  of  21.74.  Our  population  is  com- 
posed of  231,417  whites  and  95,018  colored,  which  means  that  Wash- 
ington includes  the  largest  colored  population  in  the  world. 

CAUSES  OF  LARGE  DEATH  KATES  AMONG  THE  COLORED  RACE. 

An  analysis  of  the  relative  incidence  of  the  most  fatal  diseases  on 
the  white  and  colored  race  shows  that  the  excessive  mortality  is 
especially  marked  in  pneumonia  (ratio,  1  to  3.30),  tuberculosis  of  the 
lungs  (1  to  3),  abdominal  tuberculosis  (1  to  4.10),  pulmonary  hem- 
orrhage (1  to  6.13),  diarrhea  and  enteritis  under  2  years  of  age 
(1  to  2.96),  and  typhoid  fever  (1  to  1.79),  and  is  higher  in  all  other 
diseases,  even  in  malarial  affections  (1  to  4.32),  from  which  they  were 
supposed  to  enjoy  comparative  immunity,  the  only  exceptions'^  being 
alcoholism,  delirium  tremens,  and  cirrhosis  of  the  liver,  in  which  the 
ratio  is  less  than  among  the  whites. 

It  is  not  an  easy  matter  to  account  for  this  excessive  mortality. 
In  the  first  place,  we  can  not  say  that  transferring  the  African  race 
to  a  temperate  climate  has  improved  its  physical  condition.  Negroes 
in  this  and  other  temperate  climates  are  extremely  liable  to  tubercu- 
losis and  kindred  affections.  This  must  be  attributed  not  onl}^  to 
climatic  conditions,  but  also  to  the  radical  changes  of  living,  both  as 
regards  habitation  and  food.  The  changes  from  the  native  shelter, 
with  its  natural  ventilation,  to  the  schoolroom  and  house,  the  abrupt 
change  from  native  and  simple  food  to  the  more  refined  flours  and 
sugars,  doubtless  produce  in  the  negro,  as  in  the  Indian,  a  vulner- 
ability of  the  respiratory  and  gastric  tract  to  the  invasion  of  the 
tubercle  bacillus  and  lessens  his  general  power  of  resistance.  All  of 
the  bad  effects  are  accentuated  when  one  race  mingles  with  another, 
and,  as  a  result,  a  tendency  to  degeneration  manifests  itself.  Racial 
degeneracy  has  been  defined  as  nonresistance  to  the  influences  inim- 
ical to  the  existence  of  the  race.  The  individual,  therefore,  who  can 
not  resist  the  disease-producing  causes  which  are  about  him,  whether 
they  be  germs,  climate,  or  whatever  their  nature,  is  physically  degen- 
erate. We  see  this  especially  manifested  in  the  half-breed  Indian  and 
in  the  mulatto,  neither  of  whom  is  scarcely  ever  as  robust  as  either  of 
the  races  from  whence  he  came.  The  transplantation  of  the  negro 
from  his  native  soil,  both  in  Africa  and  in  the  South,  to  less  favorable 
environments  as  regards  food  and  housing  conditions,  was  not  con- 
ducive to  his  physical  welfare.  The  housin^:  of  the  colored  popula- 
tion has  always  been  a  disgrace  to  the  national  capital,  and  even 
now  our  alley  houses  and  slums  constitute  the  main  shelter  for  nearly 
20,000  of  this  class  of  population. 


REPORTS    OF    THE   PRESIDENT'S  HOMES   COMMISSION.  211 

The  rapid  influx  of  a  negro  population  during  the  civil  war,  esti- 
mated to  have  been  between  30,000  and  40,000,  imperatively  demanded 
immediate  accommodation.  In  consequence  of  this  necessity  hovels  of 
every  description  arose,  much  of  the  material  having  been  obtained 
from  the  abandoned  army  camps  and  hospitals. 
In  the  report  of  the  board  of  health  for  1877,  page  46,  we  read: 
No  meaner  cabins  for  temporary  or  permanent  shelter  can  be  found  than 
some  our  wretched  poor  are  born  and  exist  and  die  in  here  at  the  capital 
of  the  United  States.  And,  strange  as  it  may  seem,  none  so  mean  that  they 
have  not  an  owner  mean  enough  to  charge  rent  for  them.  Down  in  the  alleys 
below  grade,  with  combination  roof  of  tar,  felt,  shingles,  rags,  tin,  gravel, 
boards,  and  holes,  floors  damp  and  broken,  walls  begrimed  by  suKjke  and  age. 
so  domiciled  are  families  with  all  the  dignity  of  tenants  having  rent  to  pay. 

This  description,  given  thirty-one  years  ago,  fits  many  of  the  habi- 
tations in  this  city  to-day,  and  the  influence  of  such  homes  upon  death 
rates  is  shown  by  the  fact  that  in  1906  the  death  rate  among  alley 
residents  was  26.96  as  compared  with  18.75  among  the  residents  of 
streets. 

It  is  known  that  90.54  per  cent  of  our  alley  population  are  colored. 
It  is  not  surprising,  therefore,  that  during  the  past  twelve  years  they 
have  contributed  5,268  out  of  the  9,534  deaths  from  consumption. 

Infantile  diarrhea,  for  reasons  given,**  is  also  more  prevalent  in  in- 
sanitary dwellings. 

Here,  again,  the  colored  population,  obliged  as  they  are  to  find 
shelter  in  houses  unfit  for  human  habitation,  contributed  in  the  last 
six  years  1,202  out  of  the  2,003  deaths  from  diarrhea  and  enteritis 
under  2  years  of  age.  The  mortality  of  children  under  1  year  of  age 
is  115.5  per  1,000  among  the  white,  and  334.86  among  the  colored. 
The  white  infantile  death  rate  of  115.5  per  1,000  is  lower  than  that 
of  any  of  the  106  American  cities,  and  also  lower  than  that  of  42 
German  cities  tabulated  by  Professor  Harrington,  while  the  rate  for 
colored  infants  is  appalling. 

It  is  likewise  a  noteworthy  fact  that,  out  of  the  1,672  deaths  from 
typhoid  fever  during  the  last  ten  years,  698  were  colored  and  974 
white.  The  rate  per  100,000  of  population  was  47.4  for  the  whites  and 
76.4  for  the  colored.  Both  rates  are  excessive,  to  be  sure,  but  the 
factor  of  environment  and  other  predisposing  causes  is  plainly  re- 
vealed by  the  undue  fatality  in  the  colored  population. 

Sufficient  reference  has  been  made  to  the  influence  of  insanitary 
homes,  but  the  mortality  rate  is  especial^  excessive  when  combined 
with  overcrowding.  Hand  in  hand,  and  not  infrequently  as  a  result 
of  such  conditions,  we  also  observe  a  greater  amount  of  abject  want, 
of  filth,  of  crime,  licentiousness,  and  other  excesses  which  predispose 
to  disease  and  even  affect  the  imborn  offspring. 

I  am  not  disposed  to  attribute  all  this  and  the  general  excessive 
mortality  rate  in  the  colored  race  to  racial  degeneracy,  because  many 
of  the  factors  are  sociological  and  to  be  found  among  the  poor  and 
ignorant  everywhere.  The  colored  element  in  Washington  represents 
to  a  large  extent  those  engaged  in  laborious  work,  probably  the  most 
exposed  to  hardships  and  inclement  weather.  Some  allowance  must 
be  made  for  this  in  computation  of  the  comparative  death  rates.  The 
broad  fact  remains,  however,  that  the  average  mortality  rate  in  the 
seven  cities  which  I  selected,  on  account  of  similarity  of  climate,  is 

«  Kober's  Industrial  Hygiene,  p.  105. 


212  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

18.01  in  the  white  population  and  27.12  for  the  colored  element,  and 
we  may  conclude  that,  while  uplifting  influences  and  higher  standards 
of  living  are  necessary  among  the  least  resourceful  classes,  regardless 
of  race,  they  are  especially  imperative  for  the  Afro- American.  That 
his  physical  welfare  responds  promptly  to  improved  environment  is 
strikingly  illustrated  by  a  decrease  in  his  general  death  rate  from 
42.86  in  1875  to  28.21  per  1,000- in  1907,  and  in  the  rate  from  con- 
sumption from  6.9  in  1878  to  4.5  in  1907. 

REGENERATION   OF   HOUSING   CX)NDITI0NS. 

The  regeneration  of  the  housing  conditions  and  removal  of  slums 
does  not  concern  a  few  well-meaning  citizens  alone,  for  the  germs  of 
typhoid  fever  may  be  carried  by  flies  from  a  patient  inhabiting  one 
of  the  alley  houses,  often  situated  in  the  interior  of  a  fine  residence 
block,  and  contaminate  the  food  and  drink  of  neighboring  homes. 
The  contagion  of  diphtheria,  scarlet  fever,  and  tuberculosis  may  be 
spread  by  servants  from  these  plague  spots  to  the  very  best  families. 

The  question  involves  both  money  and  education;  those  who  can 
not  invest  in  sanitary  homes  can  at  least  contribute  their  mite  to  the 
employment  of  trained  agents  engaged  in  the  prevention  of  sickness 
and  distress,  or  render,  what  is  far  better,  some  personal  service  in 
this  uplifting  work.  Who  can  deny  the  influence  of  a  friendly  visitor 
in  teaching  his  fellow -man  the  value  of  a  clean  home,  proper  food  and 
cooking,  and  sober  habits  in  the  preservation  of  health  and  morals  ? 

It  is  a  lamentable  fact  that  only  about  1,500  of  our  residents  are 
engaged  in  charitable  and  uplifting  influences.  The  same  men  and 
women  who  subscribe  to  the  Associated  Charities,  social  settlements, 
playgrounds,  summer  outings,  prevention  of  tuberculosis,  day  nur- 
series, visiting  nurses  to  the  poor,  and  other  philanthropic  agencies, 
have  so  far  furnished  the  means  for  the  erection  of  240  buildings, 
which  provide  clean,  healthful  homes  for  480  families.  The  wealthy 
men  are  not  adequately  represented,  nor  are  the  rank  and  file  of 
our  citizens. 

THE    PRESENT   SITUATION. 

It  is  not  difficult  to  conceive  that  health  officials  appointed  for  a 
brief  period  and  clothed  with  limited  authority  are  decidedly  handi- 
caj)ped  in  the  conduct  of  their  office,  and  as  a  result  two  such  officers 
were  found  wanting  in  the  control  of  the  sanitary  affairs  of  this  city. 

In  1895  our  present  health  officer  came  into  onice,  and  it  is  due  to 
his  intelligent  aj^preciation  of  the  needs  of  the  city  that  a  number  of 
sanitary  laws  and  regulations  have  been  framed  and  enacted.  In 
fact,  his  efforts  for  the  control  of  scarlet  fever  and  diphtheria  and 
for  a  more  rigid  system  of  food  inspection,  with  special  reference  to 
the  milk  supply,  with  corresponding  reduction  in  death  rates,  will 
stand  out  preeminently  in  the  sanitary  history  of  the  city. 

If  it  is  deemed  desirable  that  such  important  duties  and  repson- 
sibilities  should  devolve  upon  one  man,  he  should  be  sustained  by  the 
strong  arm  of  the  law.  This,  however,  in  the  very  nature  of  our 
government,  can  not  be,  and  the  result  is  that  the  health  office  is  not 
m  a  position  to  render  the  most  efficient  service.  A  health  officer  or 
board  should  be  invested  with  full  power  from  Congress  to  declare 
what  shall  be  deemed  nuisances  injurious  to  health  and  to  provide 
for  the  removal  thereof,  to  make  and  enforce  health  ordinances,  etc., 


REPORTS   OF    THE   PRESIDENT'S   HOMES   COMMISSION.  213 

subject  to  the  approval  of  the  District  Commissioners,  and  the  ap- 
pointments should  be  made,  as  in  the  case  of  the  assessor  or  chief  of 
police,  during  good  behavior. 

A  health  officer  with  an  advisory  board  of  health,  with  the  super- 
vising general  of  the  Public  Health  Service  as  a  member  ex  officio, 
would  offer  many  advantages.  The  personal  element  would  be  en- 
tirely eliminated  in  the  exercise  of  discretionary  power  and  the  health 
officer  relieved  from  grave  responsibilities  in  passing  upon  important 
problems  and  in  the  settlement  of  vexatious  questions  relating  to  the 
employment  and  discharge  of  subordinates  and  in  the  rigid  enforce- 
ment of  existing  laws  and  ordinances. 

Moreover,  municipal  hygiene  is  a  progressive  science,  and  the  Com- 
missioners and  congressional  committees  would  be  relieved  from  the 
consideration  of  details  in  the  formulation  of  sanitary  legislation  if 
these  were  acted  upon  by  a  board  of  experts.  We  do  need  more 
deliberative  bodies,  like  the  board  of  education  and  the  Board  of 
Charities,  competent  and  willing  to  give  to  the  commissioners  and 
the  public  the  benefits  of  expert  knowledge  without  regard  to  com- 
pensation. 

CONGRESS  AND  THE   HEALTH  OF  THE  DISTRICT. 

The  advocates  of  sanitary  reforms  and  the  improvement  of  housing 
conditions  gratefully  acknowledge  the  important  services  rendered 
by  Senator  Gallinger  and  other  distinguished  members  of  both 
Houses  in  the  cause  of  sanitation  of  the  national  capital.  Much  has 
been  accomplished,  but  more  remains  to  be  done  before  we  can  hope 
to  place  the  healthfulness  of  this  city  on  a  par  with  some  of  the 
European  capitals. 

Congress,  in  the  administration  of  the  affairs  of  the  District,  has  a 
sacred  duty  to  perform.  The  General  Government  owns  more  than 
one-half  of  the  property  in  the  city,  contributes  more  than  one-fourth 
of  the  population  in  the  way  of  officials  and  employees,  not  to  men- 
tion the  immense  number  of  American  citizens  who  annually  visit 
the  seat  of  government.  In  addition.  Congress  has  permitted,  during 
and  after  the  war,  40,000  negro  refugees  to  find  shelter  as  best  they 
could  in  our  midst.  For  all  this  the  United  States  simply  pays  one- 
half  the  taxes,  no  more ;  and  no  infrequently  has  paid  less. 

As  sanitarians,  we  contend  that  in  building  a  city,  the  capital  of 
a  gigantic  nation,  the  first  care  should  be  the  protection  of  the  health 
of  its  people.  Its  beautifying  is  essential,  but  of  secondary  im- 
portance. Economy,  however  laudable  its  general  purpose,  should 
never  be  exercised  at  the  expense  of  public  health. 


Chapter  VII. 

SEXUAL  AND  MORAL  PROPHYLAXIS. 

In  this  connection  it  may  not  be  out  of  place  to  refer  to  diseases 
arising  from  impure  sexual  intercourse,  whether  it  be  a  simple  ex- 
coriation, which  has  been  inoculated  with  some  one  of  the  septic 
germs,  or  whether  it  be  an  inflammation  of  the  urethra  produced  by 
a  specific  discharge,  or  whether  it  be  one  of  the  forms  of  syphilis 
as  now  recognized. 

The  absence  of  reliable  statistics  in  venereal  diseases  is  very  much 
to  be  deplored,  for  if  we  wish  to  approach  the  subject  intelligently 


214 


REPOKTS   OF  THE  PRESIDENT  S  HOMES  COMMISSION. 


we  should  know  something  more  definite  as  to  their  prevalence  in 
civil  life. 

An  appropriate  idea  may  be  gotten  by  a  study  of  army  statistics. 
Doctor  Munson   (in  his  Military  Hygiene,  p.  823)  gives  the  latent  / 
admission  rate  per  1,000  strength,  as  follows: 


Germany 27.  9 

Russia 36.  0 

Japan 36.0 

France 40.  9 

Holland 4S.  1 


Austria-Hungary. 61.  0 

United    States 73.7 

Great  Britain: 

Home    statistics 173.8 

Indian   statistics ^___  522.  3 


Annual   admission   rate   per   1,000   strength   for   the    three    years,    1890->1S92 

(Munson), 


Primaryand 
secondary 
syphilis. 


All  other 
venereal 


Germany 

France 

Russia 

Italy 

United  States 

Dutch  troops  (home  statistics 

East  Indies 

British  troops: 

Home  statistics 

Indian  statistics 


5.50 
9.00 
13.10 
13.90 

16.83 
14. 80 
47.00 

101.70 
175. 40 


21.50 
34,90 
29.90 
57.40 
57.96 
55.00 
408.60 

101.90 
262. 60 


It  is  a  lamentable  fact  that  the  very  countries  in  which  the  senti- 
ment, both  in  and  out  of  the  profession,  is  strongly  against  recogniz- 
ing the  evil,  furnish  the  highest  army  rates,  while  in  countries  where 
some  special  regulations  are  in  force  preventing  the  spread  of 
venereal  diseases,  such  as  weekly  inspections  of  the  men  and  periodi- 
cal examination  of  the  women  engaged  in  prostitution,  with  compul- 
sory isolation  if  such  are  found  diseased,  the  army  rates  are  lowest. 

The  comparative  amount  of  army  and  civil  venereal  diseases  is 
not  known,  because  we  have  no  statistics  of  the  amount  in  civil  life. 

According  to  Fournier  one-seventh  of  the  population  of  Paris  is 
syphilitic,  and  the  mortality  of  infants  born  of  syphilitic  parents  in 
many  hospitals  of  that  city  reaches  84  to  86  per  cent. 

According  to  Doctor  Weiss,  there  are  150,000  syphilitics  in  Berlin, 
or  12  per  cent  of  the  inhabitants. 

In  1901  a  committee  of  seven,  under  the  auspices  of  the  Medical 
Society  of  the  County  of  New  York,  made  an  investigation  into  the 
prevalence  of  venereal  diseases,  and  from  the  information  received 
from  private  physicians,  reports  of  the  hospitals  and  dispensaries 
concluded  that  there  were  not  less  than  243,000  cases  of  venereal  dis- 
eases treated  in  one  year  in  that  city.  During  the  same  year  there 
were  only  41,585  other  cases  of  infectious  of  communicable  diseases 
reported  to  the  health  department,  viz,  measles,  12,570;  diphtheria, 
11,001;  tuberculosis,  8,877;  scarlet  fever,  7,787;  chicken  pox,  99.  In 
other  words,  the  morbidity  from  venereal  diseases  was  nearly  six 
times  greater  than  that  from  all  the  above-named  infectious  diseases 
combined. 

Parkes  of  England  says : 

It  Is  a  question  whether  a  large  number  of  the  young  men  of  the  upper  and 
middle  classes  do  not  suffer  in  youth  from  some  form  of  venereal  disease.  In 
the  lower  classes  it  is  perhaps  equally  common. 


BEPORTS   OF    THE  PRESIDENT'S   HOMES   COMMISSION.  215 

Neisser,  of  Germany,  holds  that  gonorrhea  is,  with  the  exception 
of  perhaps  measles,  the  most  widespread  of  all  diseases.  Other  Ger- 
man authorities  have  computed  that  fully  three-quarters  of  the  adult 
male  population,  and  one-sixth  or  more  of  the  adult  females  have 
contracted  gonorrhea,  and  that  15  per  cent  of  the  population  is 
syphilitic. 

Dr.  Prince  A.  Morrow,  based  upon  a  large  personal  experience  and 
the  results  of  the  New  York  and  Baltimore  investigations  by  com- 
mittees on  sanitary  and  moral  prophylaxis,  says : 

Assuming  from  experience  and  tlie  statistics  collected  in  New  York  and  in 
Baltimore  that  our  population  is  more  virtuous  than  that  of  Europe,  it  must 
be  a  conservative  estimate  that  in  this  country  the  morbidity  from  gonorrhea 
would  represent  60  per  cent  of  the  adult  male  population,  and  that  of  syphilis 
from  10  to  15  per  cent,  which  would  mean  that  between  3,000,000  to  4,000,000  cases 
are  annually  treated  in  this  country.  According  to  Morrow,  20  per  cent  of 
the  cases  occur  before  the  twenty-first  year,  60  per  cent  before  the  twenty-sixth 
year,  and  10  per  cent  of  the  men  who  marry  infect  their  wives.  The  report  of 
the  New  York  committee  "would  indicate  that  nearly  30  per  cent  of  all  vene- 
real infections  occurring  in  women  in  private  practice  in  that  city  are  commu- 
nicated by  their  husbands ;  "  and  from  his  personal  observation  at  the  New 
York  Hospital,  extending  over  a  period  of  several  years,  he  concludes  that 
"  fully  70  per  cent  of  all  women  who  come  therein  for  treatment  were  respect- 
able married  women  who  had  been  infected  by  their  husbands." 

VICE   DISEASES    IN    THE   DISTRICT   OF    COLUINIBIA. 

Dr.  Henry  C.  Macatee,  of  the  President's  Homes  Commission,  has 
made  a  special  study  of  the  prevalence  of  so-called  "  vice  diseases  "  in 
the  District  of  Columbia.  The  results  have  been  tabulated  and  will 
be  found  in  Table  B.  The  period  covers  nine  years,  except  in  the  case 
of  Providence  Hospital,  Columbia  Hospital,  and  the  Children's  Hos- 
pital, for  which  institutions  the  data  cover  only  two  years.  From 
this  table  it  appears  that  out  of  a  total  of  274,611  patients  treated 
38,183  cases  were  vice  diseases,  viz,  9,869  syphilitic  affections,  3,643 
cases  of  chancroids,  and  14,435  cases  of  gonorrheal  affections.  In 
addition  to  the  27,947  cases  of  sexual  diseases  there  Avere  treated  9,510 
patients  for  alcoholism,  409  for  delirium  tremens,  256  for  the  opium 
habit,  and  61  for  the  cocaine  habit;  an  average  of  4,243  cases  per 
annum  of  vke  diseases,  or  nearly  one-seventh  of  all  the  cases  treated 
in  the  city  hospitals.  As  a  matter  of  fact,  23.6  per  cent  of  all  the 
cases  treated  in  the  Washington  Asylum  Hospital  and  31.6  per  cent 
of  those  treated  in  the  workhouse  were  vice  diseases.  The  majority 
of  the  patients  treated  in  the  hospitals  belonged  to  the  dependent 
classes.  We  have  no  statistics  as  to  the  prevalence  of  vice  diseases 
among  the  middle  and  upper  classes. 


216 


EEPORTS  OF   THE  PRESIDENT  S   HOMES  COMMISSION". 


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BEPORTS   OF   THE   PEESIDENT  S   HOMES   COMMISSION. 


217 


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218 


REPORTS  OF   THE  PRESIDENT  S  HOMES  COMMISSION. 


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KEPOKTS    OF    THE  PRESIDENT  S  HOMES   COMMISSION. 


219 


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220  REPOKTS  OF   THE  PEESIDENt's  HOMES  COMMISSION. 

SYPHILIS. 

This  disease  first  attracted  attention  in  Europe  in  the  latter  decade 
of  the  fifteenth  century.  During  the  siege  of  Naples  by  the  French 
troops  under  the  command  of  Charles  VIII  in  1495,  a  disease  char- 
acterized by  ulcers  on  the  genitals,  general  eruptions  of  the  skin, 
violent  pains  in  the  head  and  limbs  broke  out  among  the  French  sol- 
diers and  the  civil  population,  and  after  the  return  of  the  French 
soldiers  the  disease  appears  to  have  spread  rapidly  throughout  France 
and  Europe.  Quite  early  in  the  history  it  was  recognized  that  the 
disease  was  principally  contracted  during  sexual  intercourse  and 
hence  was  named  lues  venerea,  while  the  populace  commonly  spoke  of 
it  as  the  Frenchman's  disease.  The  real  nature  of  syphilis  remained  a 
mystery  until  two  years  ago,  when  an  organism  was  isolated  called  the 
"  spirocheta  pallida,"  which  is  believed  to  be  the  causative  factor. 
This  micro-organism  evidently  clings  to  the  secretions  of  syphilitic 
ulcers,  to  the  tissues  of  diseased  organs,  and  possibly  also  invades  the 
blood  and  the  mammary  glands  after  it  has  ceased  to  be  a  purely  local 
affection.  The  virus  may  be  conveyed  m  an  extragenital  way  by 
kisses,  use  of  infected  pipes,  cigars,  and  cigarettes ;  by  glass  blowers 
and  the  mouthpieces  of  wind  instruments;  by  dental  and  surgical 
instruments;  by  the  act  of  suckling,  from  infants  to  nurse  and  con- 
versely; in  tattooing,  and  during  digital  examination  by  physicians, 
in  case  of  abraded  surfaces,  hangnails,  etc.  There  is  every  reason  for 
assuming  that  the  virus  may  be  transmitted  to  the  offspring,  either 
through  the  sperma  or  the  blood  of  a  syphilitic  mother. 

Syphilis  is  indeed  a  disease  of  the  blood  and  affects  every  tissue  of 
the  body.  Apart  from  the  long  duration  of  the  disease,  and  the 
pecuniary  losses  involved  by  care  and  treatment  and  arrest  of  the 
earning  capacity,  its  effect  upon  longevity  and  procreation  are  most 
destructive. 

Syphilis  is  responsible  for  42  per  cent  of  abortions  and  miscar- 
riages, from  60  to  86  per  cent  of  the  offsprings  of  syphilitics  die  before 
or  shortly  after  birth,  and  those  who  survive  are  subjects  of  degen- 
erative and  organic  defects,  transmitted  to  future  generations.  Four- 
nier's  personal  statistics  show  that  90  women  infected  by  their  hus- 
bands became  pregnant  in  the  first  year  of  married  life ;  50  of  these 
aborted,  40  carried  the  offspring  to  full  term,  but  of  these  only  2  sur- 
vived. He  also  gives  statistics,  based  upon  authentic  sources,  where 
syphilis  has  practically  extinguished  the  posterity  of  certain  families. 
One  table  gives  out  of  216  births  183  deaths;  another  out  of  157 
births  157  deaths,  or  a  mortality  of  100  per  cent. 

The  disease  swells  the  number  of  inmates  of  almshouses,  asylunis 
for  the  insane,  and  homes  for  incurables,  wrecks  the  health  and  happi- 
ness of  many  families,  and  leads  to  premature  decay.  Morrow  states 
that  "  every  case  of  hemiplegia  occurring  in  a  man  less  than  40 
years  of  age,  not  addicted  to  alcohol  or  affected  with  lesions  of  the 
circulatory  system,  is  eight — or,  more  correctly,  nine — times  out  of 
ten  of  syphilitic  origin. 

"  The  proportion  of  ocular  paralysis  resulting  from  syphilis  is  about 
75  per  cent  on  the  average.  *  *  *  In  statistics  embracing  743 
cases  of  cerebral  syphilis^  354  of  which  were  followed  up  to  a  known 
termination,  77  were  cured,  68  died,  while  the  remaining  209  sur- 


EEPORTS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  221 

vived,  but  with  various  infirmities  of  a  grave  character  and  in  every 
case  irremediable." 

According  to  the  statistics  of  Erb,  Althaus,  Fournier,  and  others, 
from  80  to  90  per  cent  of  the  cases  of  locomotor  ataxia  are  of  syphi- 
litic origin.  In  3,429  cases  of  tertiary  syphilis  Fournier  found  dis- 
eases of  the  nervous  system  in  1,085  instances,  cerebral  syphilis  in 
461,  spinal  affections  in  40,  general  paralysis  in  32  cases. 

GONORRHEA. 

This  disease,  so  often  regarded  as  a  trivial  affection  by  frivolous 
young  men,  is  also  specific  in  character,  caused  by  a  micro-organism 
discovered  by  Neisser  in  1879.  The  organism  clings  to  the  discharges 
in  acute  and  chronic  cases  and  may  persist  long  after  the  disease  is 
apparently  arrested.  While  at  first  a  purely  local  affection,  it  may 
produce  destructive  inflammation,  resulting  in  stricture  of  the 
urethra;  it  may  also  extend  to  the  testicle,  prostate  gland,  bladder, 
and  kidneys,  and  ultimately  affect  the  heart,  joints,  and  other  vital 
organs.  Indeed,  the  disease  is  believed  to  be  responsible  for  more 
misery,  ill  health,  and  race  suicide  than  any  other  sociological  factor. 

The  average  duration  of  acute  cases  is  from  four  to  six  weeks,  but 
there  are  a  large  number  of  chronic  cases  requiring  at  least  six 
months'  careful  treatment,  and,  according  to  the  investigations  of  a 
committee  of  the  American  Medical  Association,  3  per  cent  of  the 
cases  are  practically  incurable.  One  of  the  most  baneful  effects  is 
the  latency  of  the  disease  and  the  great  danger  of  communicating  the 
virus  to  wives  by  husbands  who  considered  themselves  as  having 
been  cured  before  marriage.  It  is  certainly  startling  to  be  told  by 
competent  specialists  that  fully  80  per  cent  of  all  the  operations  for 
inflammatory  diseases  peculiar  to  women,  practically  all  the  pus 
tubes,  75  per  cent  of  the  suppurative  inflammations  of  the  pelvic 
organs,  70  per  cent  of  all  the  work  done  by  specialists  for  diseases 
peculiar  to  women  are  of  gonorrheal  origin.  It  is  equally  appalling 
to  realize  that  the  same  germs  are  the  cause  of  blenorrhea  neonatu- 
rum,  a  purulent  affection  of  the  eyes  of  new-born  children,  which 
contributes  a  contingent  to  our  asylums  for  the  blind  of  from  10  to 
20  per  cent — from  40  to  60  per  cent  before  the  Crede  method  of  pre- 
vention was  instituted.  Dr.  Swan  M.  Burnett,  professor  of  oph- 
thalmology, Georgetown  University,  expressed  the  conviction  that 
at  least  15,000  of  the  50,000  blind  persons  in  the  United  States 
lost  their  sight  from  this  cause,  involving  a  financial  loss  to  the  com- 
monwealth of  seven  and  one-half  millions  annually. 

The  destructive  effects  of  gonorrhea  on  the  procreative  functions 
have  been  very  properly  emphasized  in  connection  with  the  "race- 
suicide  problem."  Neisser  maintains  that  gonorrhea  is  even  a  more 
potent  factor  than  syphilis  in  sterility,  and  that  more  than  45  per 
cent  of  all  involuntary  childless  marriages  are  due  to  this  cause. 

The  remedial  measures  which  have  been  proposed  for  the  pre- 
vention of  these  diseases  and  which  affect  not  only  the  offender,  but 
the  wives,  the  offspring  and  not  infrequently  also  perfectly  innocent 
persons  are  numerous  enough,  but  not  so  easy  of  application.  Since 
the  chief  source  of  infection  is  prostitution,  the  sanitarian  suggests 
that  a  person  afflicted  with  a  venereal  disease  is  quite  as  much  a 


222  REPORTS   OF   THE   PRESIDENT'S   HOMES   COMMISSION. 

menace  to  public  health  as  would  be  a  case  of  smallpox  or  any  other 
communicable  disease  and  points  with  emphasis  to  what  has  been 
accomplished  in  Europe  in  the  way  of  official  control  of  prostitution, 
as  a  lesser  evil,  by  registration  of  brothels  and  their  inmates,  periodi- 
cal inspections,  and  the  detection  and  cure  of  diseased  men  and 
women.  He  will  tell  us,  and  the  statistics  will  support  him,  that 
the  prevalence  of  venereal  diseases  is  least  where  sanitary  measures 
are  most  vigorously  enforced. 

The  medical  profession  is  by  no  means  agreed  as  to  the  propriety 
of  this  method,  mainly  because  such  a  system  seems  too  much  like  a 
recognition  of  the  inevitableness  of  the  social  evil  and  practically  an 
official  sanction  of  it.  Others,  moreover,  with  good  reason  assert 
that  licensing  and  sanitary  inspection  t^nd  to  produce  clandestine 
prostitution,  which  has  heretofore  furnished  the  largest  number  of 
syphilitic  cases.  On  the  whole,  we  may  conclude  that  health  officers 
in  this  country  are  not  prepared  to  advocate  the  European  plan  of 
inspection  and  license. 

CRUSADE   AGAINST   THE   SOCIAL   EVIL.<» 

The  subject  of  prostitution  has  always  been  considered  of  great 
sociological  and  economic  importance  by  persons  who  have  witnessed 
the  sad  effects  among  the  inmates  of  hospitals,  prisons,  almshouses, 
asylums  for  the  blind,  etc.  It  is  gratifying  to  note  that  in  1858,  just 
fifty  years  ago,  a  most  intelligent  and  painstaking  study  was  made 
by  Dr.  Wm.  W.  Sanger,  resident  physician  of  Blackwells  Island, 
under  the  auspices  of  the  governors  of  the  almshouse  of  the  city  and 
county  of  New  York.  A  few  passages  from  the  introduction  are  re- 
produced, for  they  are  as  applicable  now  as  when  first  indited  by  his 
graceful  pen : 

Hitherto  reticence  has  been  the  policy.  This  position  has  been  held  too  long, 
for  it  is  false  in  principle  and  injurious  in  tendency.  The  day  has  arrived 
when  the  shroud  must  be  removed,  when  the  public  safety  imperiously  demands 
an  investigation  into  the  matter;  when  those  who  regard  it  as  a  small  wrong 
may  have  their  attention  directed  to  its  real  proportions.  *  *  *  ^  small 
matter  it  decidedly  is  not.  *  *  *  Nor  is  it  unmanageable  except  when  con- 
cealed. Stripped  of  the  veil  of  secrecy  which  has  enveloped  it,  there  appears 
vice  arising  from  an  inextinguishable  natural  impulse  on  the  part  of  one  sex, 
fostered  by  confiding  weakness  in  the  other ;  from  social  disabilities  on  one  side 
and  social  oppression  on  the  other ;  from  the  wiles  of  the  deceiver  working  upon 
unsuspecting  credulity,  and,  finally,  from  the  stern  necessity  to  live. 

The  book  covers  676  pages,  and  is  the  first  effort  on  the  Western 
Continent  in  sexual  and  moral  prophylaxis,  but  unfortunately  has  so 
far  been  fruitless  on  account  of  the  general  apathy  on  the  part  of  the 
general  public. 

Some  of  the  facts  brought  out  in  the  detailed  investigation  of  2,000 
prostitutes  in  New  York  City  are  of  sufficient  interest  to  be  adduced. 
Of  the  entire  number  750  were  between  15  and  20  years,  1,154  be- 
tween 21  and  39,  and  96  over  40  years  of  age;  1,238  were  foreign 
born  and  762  natives  of  the  United  States.  Of  the  latter  the  majority 
hailed  from  New  York,  New  Jersey.  Connecticut,  Massachusetts, 
Maine,  New  Hampshire,  and  Vermont.     Doctor  Sanger  is  inclined 

o  I  am  indebted  to  my  friend  Dr.  Edward  L.  Morgan  for  a  number  of  valuable 
references  to  the  literature  of  the  subject. 


REPORTS    OP    THE   PRESIDENT'S  HOMES   COMMISSION.  223 

to  attribute  this  to  the  employment  of  a  much  larger  proportion  of 
females  in  manufacturing  and  sedentary  occupations,  and  says : 

A  young  woman  of  ardent  temperament  can  not  but  feel  the  hardship  of 
this  position  in  life ;  *  *  *  thus,  when  already  predisposed  in  favor  of  any 
change,  she  falls  into  the  hands  of  the  tempter  a  pliant  victim.  *  *  *  Be- 
yond the  hardships  attendant  on  her  daily  labor  the  associations  which  are 
formed  in  factories  or  workshops,  where  both  sexes  are  employed,  very  fre- 
quently result  disastrously  for  the  female.     *     *     * 

In  speaking  of  the  foreign  class  the  author  says : 

Many  of  the  females  become  mothers  almost  as  soon  as  they  land  on  these 
shores;  in  fact,  the  probability  of  such  an  event  sometimes  hastens  their  de- 
parture. They  exist  here  in  the  most  squalid  misery  in  some  tenement  house 
or  hovel.  Their  children  receive  none  of  the  advantages  of  education,  for  as 
soon  as  they  can  beg  they  are  compelled  to  aid  in  the  struggle  for  bread  and  the 
most  frequent  result  is  that  the  boys  are  arrested  for  some  petty  theft  and  the 
girls  become  prostitutes,  thus  contributing  to  meet  the  demand  caused  by  the 
classes  already  mentioned. 

In  this  connection  attention  is  called  to  Judge  De  Lacy's  letter, 
page  380. 

Of  the  2,000  persons  investigated  490  were  married,  71  of  whom 
still  lived  with  their  husbands;  103  left  their  husbands  on  account 
of  ill  usage,  60  were  deserted  by  their  husbands,  43  were  deserted 
by  husbands  to  live  with  other  women ;  others  left  their  homes  on  ac- 
count of  nonsupport,  drunkenness,  infidelity,  and  in  75  no  specific 
cause  was  assigned.  There  were  also  294  widows  in  the  general  list. 
The  author  believes  the  principal  conclusion  to  be  drawn  from  the 
table  which  he  presents  "  is  that  the  majority  of  this  class  (widows) 
are  driven  to  a  course  of  vice  from  the  destitution  ensuing  on 
her  husband's  death.  It  has  been  shown  that  a  large  number  of 
them  are  very  young  and  it  can  be  scarcely  necessary  to  repeat  that 
any  young  woman  in  a  state  of  poverty  will  be  surrounded  with  temp- 
tations she  can  with  difficulty  resist.  Much  as  this  state  of  society 
may  be  deplored,  its  existence  can  not  be  denied." 

The  section  dealing  with  the  hidden  springs  of  the  evil  is  of  ex- 
treme interest.  The  causes  assigned  by  the  women  themselves  are 
as  follows : 

Inclination,  513;  destitution,  525;  seduced  and  abandoned,  258; 
drink  and  a  desire  to  drink,  181 ;  ill  treatment  of  parents,  relations, 
or  husbands,  164;  as  an  easy  life,  124;  bad  company,  84;  persuaded 
by  prostitutes,  71 ;  too  idle  to  work,  29 ;  violated,  27 ;  seduced  on  board 
of  emigrant  ships  or  in  emigrant  boarding  houses,  24. 

Doctor  Sanger,  in  discussing  the  subject  of  inclination,  adduces 
considerable  evidence  to  show  "  that  if  a  positive  inclination  to  vice 
was  the  proximate  cause  of  the  fall,  it  was  but  the  result  of  other 
and  controlling  influenced."  Most  pathetic  instances  of  how  destitu- 
tion, seduction,  and  other  predisposing  causes  led  to  the  degradation 
will  be  found  on  pages  489-522. 

Of  the  2,000  cases  examined  witli  reference  to  previous  occupation, 
933  belonged  to  the  servant  class,  499  lived  with  parents  or  friends, 
285  were  dressmakers,  tailoresses,  and  seamstresses,  and  the  remain- 
der were  engaged  in  miscellaneous  occupations;  534  claim  to  have 
earned  only  $1  per  week;  336,  $2  a  week;  230,  $3;  127,  $4;  68,  $5;  27, 
$6;  8,  $7;  5,  $8;  two  had  earned  over  $20  a  week,  and  in  663  the 
question  of  earnings  was  not  ascertained. 


224  REPOETS   OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

The  investigation  revealed  the  fact  that  947  of  the  2,000  women 
became  mothers.  Of  these,  357  single  women  had  490  children,  357 
married  women  had  791  children,  and  233  widows  had  636  children. 
Of  the  1,917  children  born,  1,185  had  died  before  the  inquiry,  and 
732  were  alive.     The  ratio  of  mortality  was  as  follows ; 

Children  of —  Per  cent. 

Single    women • 73 

Married  women 58 

Widows 59 

An  average  of  62  per  cent,  or  more  than  six  deaths  for  every  10 
children  born.  On  page  487  of  the  book  it  is  shown  that  821  of  the 
2,000  investigated  had  contracted  specific  diseases  incident  to  prosti- 
tution, viz:  Gonorrhea  in  250  instances,  gonorrhea  and  syphilis  in 
36,  and  syphilis  in  535  cases.  The  difficulty  of  securing  such  informa- 
tion is  very  great  and  the  probability  is  that  the  real  number  far 
exceeds  this  average,  but  the  confessed  facts  are  quite  sufficient  to 
estimate  the  amount  of  public  mischief  resulting  daily  from  a  mass  of 
prostitutes. 

The  appendix  to  the  edition  of  Doctor  Sanger's  book,  published  in 
1906,  states  that  Doctor  Sanger  in  1858  placed  the  number  of  public 
prostitutes  in  New  York  at  6,000,  or  one  in  every  117  inhabitants, 
while  a  conservative  estimate  would  now  place  their  number  at  30,000, 
or  one  in  about  55  of  the  resident  population. 

In  1902  the  committee  of  fifteen,  composed  of  prominent  citizens, 
presented  a  report  on  the  social  evil  with  special  reference  to  condi- 
tions existing  in  the  city  of  New  York,  but  found  it  impossible  to 
approximate  the  number  of  prostitutes  or  houses  of  prostitution; 
evidence  was  secured,  however,  of  over  300  separate  disorderly  apart- 
ments in  tenement  houses.  In  many  of  these  tenement  houses  as 
many  as  50  children  resided.  An  acquaintance  by  the  children  with 
adult  vices  was  inevitable.  Almost  any  child  on  the  East  Side  in 
New  York  will  tell  you  what  a  "  nafke  bias "  is.  *  *  *  The 
statistics  of  venereal  diseases  among  children  and  the  many  revolt- 
ing stories  from  the  red-light  district  tell  how  completely  they  learned 
the  lessons  taught  them. 

Mr.  George  Kibbe  Turner,  in  a  recent  magazine  article,  presents  a 
study  of  the  great  immoralities  in  the  city  of  Chicago,  and  estimates 
"  the  gross  revenues  from  prostitution  in  Chicago  in  1906  at 
$20,000,000,  and  probably  more.  There  are  at  least  10,000  profes- 
sional prostitutes.  Annual  average  receipts  of  $2,000  each  are 
brought  in  by  these  women.  They  do  not  themselves,  however,  have 
the  benefit  of  this  revenue.  Much  of  it  is  never  received  by  them. 
They  are,  in  fact,  exploited  by  large  business  interests.  There  are 
four  large  interests  which  are  concerned  in  the  exploitation  of  pros- 
titution. The  first  of  these  is  the  criminal  hotels,  the  second  is  the 
houses  of  ill-fame;  the  third,  the  cheap  dance  halls  and  saloons,  and 
the  fourth,  the  men — largely  Russian  Jews — Avho  deal  in  women  for 
the  trade."  *  *  *  Major  Sylvester,  the  chief  of  police  of  Wash- 
ington, estimates  that  there  are  about  400  prostitutes  m  this  city,  con- 
fined almost  wholly  to  a  certain  district,  and  that  special  pains  have 
been  taken  by  the  police  to  prevent  minors  from  frequenting  these 
places. 

A  recent  investigation  by  the  Department  of  Commerce  and  Labor 
shows  that  there  are  62  houses  of  prostitution,  with  365  white  inmates, 


EEPOETS   OP   THE  PEESIDENT's  HOMES   COMMISSION.  225 

of  whom  68  were  of  foreign  birth,  and  16  houses  with  105  colored 
females,  all  natives  of  this  country.  It  is  gratifjdng  to  know,  from 
an  official  source,  that  the  number  of  prostitutes  in  Washington  is 
placed  at  470. 

In  the  crusade  against  the  social  evil  every  effort  heretofore  made, 
spasmodically  to  be  sure,  has  been  to  apprehend  the  female  offender, 
and  all  such  attempts  have  simply  resulted  in  secret  prostitution, 
which  is  far  more  dangerous  in  its  social  and  sanitary  aspects.  Indeed 
every  attempt  to  make  laws  upon  the  subject  which  apply  to  women 
and  not  to  men  is  most  unjust  and  establishes  a  different  standard 
of  morality  for  the  two  sexes. 

As  expressed  by  Morrow,  "the  prostitute  is  but  the  purveyor  of 
the  infection.  She  simply  returns  to  her  male  partner,  the  pros- 
tituant,  as  he  is  termed,  the  infection  she  has  received  from  another 
prostituant.  In  the  ultimate  analysis  it  will  be  found  *  *  *  that 
the  most  essential  cause,  the  causa  causans,  of  prostitution  is  mascu- 
line unchastity — the  polygamous  proclivities  and  practice  of  the  male, 
which  lead  him  to  seek  the  gratification  of  his  sexual  instinct 
wherever  and  whenever  he  can  find  a  receptive  partner.  *  *  * 
The  woman  owes  her  fall  to  the  aggressive  solicitations  or  seductions 
of  the  man.  She  may  even  be  a  quasi  willing  victim,  but  she  yields 
rather  from  sentimental  feeling  than  from  sexual  inclination. 
*  *  *  Women  are  the  most  pitiless  and  unrelenting  in  the  ostra- 
cism of  those  of  their  sex  who  have  crossed  the  Rubicon  of  virtue. 
The  virtuous  matron  who  would  shield  her  daughter  from  all  contact 
with  a  fallen  sister  as  contaminating,  with  most  indulgent  charity 
smiles  upon  the  very  man  who  may  have  been  the  author  of  her  ruin ; 
she  may,  indeed,  receive  him  as  a  suitor  for  her  daughter  if  he  is 
otherwise  eligible.  *  *  *  As  a  result  of  this  double  standard  of 
morality,  society  practically  separates  its  women  into  two  classes — 
from  the  one  it  demands  chastity ;  the  other  is  set  apart  for  the  grat- 
ification of  the  sexual  caprices  of  its  men.  It  thus  proclaims  the 
doctrine,  immoral  as  it  is  unhygienic,  that  debauchery  is  a  necessity 
for  its  men." 

EDUCATIONAL  METHODS. 

On  the  whole,  the  present  writer  believes  the  remedy  lies  in  public 
education.  The  great  majority  of  the  people  have  no  knowledge  of 
the  subject,  simply  because  of  the  erroneous  assumption  that  it  is 
not  one  which  lends  itself  to  general  discussion. 

It  is  indeed  gratifying  that  such  a  respectable  magazine  as  the 
Ladies  Home  Journal  has  given  attention  to  topics  of  this  character 
and  insisted  for  several  years  upon  a  greater  parental  frankness  with 
children  about  their  physical  selves.  In  the  editor's  personal  page, 
in  the  issue  of  September,  1908,  we  find  the  following  courageous 
statement : 

Because  of  tlie  secrecy  with  which  the  whole  question  is  enshrouded  it  Is 
practically  impossible  to  obtain  absolute  figures.  But  so  far  as  the  highest 
authorities  have  been  able,  through  the  most  careful  inquiries,  to  secure  ac- 
curate figures,  it  is  a  conservative  statement  to  make  that  at  least  60  out  of 
every  100  young  men  are  to-day  "  sowing  their  wild  oats."  Of  these  60  young 
men  a  startling  number  are  either  already  making  or  will  make  a  tragedy  of 
marriage.  They  produce  either  childless  homes,  dead-born  or  blind  babies; 
children   with  lifelong  diseases  with  them,  or  they  will  send  thousands  of 

S.  Doc.  644,  60-2 16 


226  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

women  to  the  operating  table.  ♦  *  *  This  frightful  condition  has  been 
brought  about  largely  by  two  contributing  factors:  (1)  The  parental  policy  of 
mock  modesty  and  silence  with  their  sons  and  daughters  about  their  physical 
selves,  and  (2)  the  condoning  in  men  what  is  condemned  in  women.  Fathers 
and  mothers,  and  in  consequence  girls,  have  condoned  in  a  young  man  this 
sowing  of  his  "  wild  oats,"  because  it  was  considered  a  physical  necessity ; 
that  it  "  would  do  him  good ;"  that  it  "  would  make  a  man  of  him ;"  that  "  it 
would  show  him  the  world" — all  arguments  absolutely  baseless.  The  reme- 
dies proposed  are  along  the  principles  already  indicated,  viz,  knowledge  of 
the  subject,  and  that  "  we  fathers  of  daughters  must  rid  ourselves  of  the 
notion  that  has  worked  such  diabolical  havoc  of  a  double  moral  standard. 
There  can  be  but  one  standard — that  of  moral  equality.  Instead  of  being  so 
painfully  anxious  about  the  "  financial  prospects  "  of  a  young  man,  *  *  * 
it  is  time  that  we  put  health  first  and  money  second.  *  *  *  Let  a  father 
ask  the  young  man,  as  the  leading  question,  whether  he  is  physically  clean ; 
insist  that  he  shall  go  to  his  family  physician,  and  if  he  gives  him  a  clean  bill 
of  health,  then  his  financial  prospects  can  be  gone  into.  But  his  physical  self 
first.  That  much  every  father  would  do  in  the  case  of  a  horse  or  a  dog  that 
he  bought  with  a  view  to  mating.  Yet  he  does  less  for  his  daughter,  his  own 
flesh  and  blood.  Once  let  young  men  realize  that  such  a  question  would  be 
asked  them  by  the  father  of  the  young  women  whom  they  would  marry;  that 
a  physical  standard  would  be  demanded,  and  that  knowledge  would  be  more 
effective  for  morality  among  young  men  than  all  the  preaching  and  moraliz- 
ing and  exhortations  of  the  past  thousand  years.  Thus,  and  thus  only,  can 
we  save  our  daughters  and  their  unborn  children.    But  in  no  other  way. 

It  should  be  stated  in  justice  to  my  friend  and  teacher  that  the  late 
Dr.  J.  Harry  Thompson,  then  in  charge  of  the  Columbia  Hospital 
for  Women  in  Washington,  as  early  as  1873  advocated  the  plan  of 
insisting  upon  a  clean  bill  of  health,  and  related  to  the  class  an  in- 
stance in  which  the  young  man,  after  complying  with  what  he  con- 
sidered a  reasonable  parental  request,  told  the  father : 

Now,  that  I  have  furnished  you  with  evidence  of  my  own  physical  cleanness, 
I  shall  insist  upon  a  similar  evidence  in  your  case,  as  I  am  equally  anxious 
to  perpetuate  the  purity  of  my  blood. 

To  which  request  the  father  unhesitatingly  acceded. 

As  a  teacher  of  hygiene  I  can  not  find  words  strong  enough  in  com- 
mendation of  the  brave  editorial  and  the  excellent  article,  "  The 
tragedy  of  the  marriage  altar"  (by  Dr.  Abraham  L.  Wolbarst),  in 
the  Ladies  Home  Journal  for  September  and  October,  1908.  The 
writer  has  realized  for  years  the  necessity  of  proper  education,  for  if 
we  expect  the  parents  to  impart  information  on  sexual  purity,  they 
must  acquire  it  primarily  from  some  competent  and  reliable  source. 
Few  of  our  magazine  writers  have  heretofore  been  brave  enough  to 
present  this  question  as  the  Ladies  Home  Journal  has  done.  For 
all  these  reasons  I  have  advocated  for  years  that  hygiene  should  form 
part  of  the  curriculum  in  our  public  schools  and  the  question  discussed 
from  the  standpoint  of  sexual  hygiene  pure  and  simple.  Public  lec- 
turers on  the  purity  of  man  commit  a  serious  mistake,  generally,  when 
they  picture  the  consequences  of  the  social  evil  without  offering  a 
suitable  remedy.  Many  a  young  man  thinks  it  essential  to  his  health 
to  give  vent  to  his  penned  up  secretions  by  sexual  intercourse  and  to 
demonstrate  his  manhood.  If  deterred  by  fear  of  contracting  venereal 
diseases,  in  the  absence  of  other  remedies  he  will  most  likely  resort  to 
unnatural  methods. 

We  should  make  a  strong  plea  in  favor  of  continence,  and  tell  our 
young  men  that,  while  the  sexual  passion  is  very  strong,  it  can  be 
accelerated  or  delayed,  excited  or  lowered,  by  the  influence  of  the  will. 
We  should  assure  them  that  sexual  indulgence  is  not  a  physiological 


EEPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION.  227 

necessity,  and  that  nature  will  relieve  herself  by  an  occasional  noc- 
turnal emission.  By  the  cultivation  of  pure  thoughts,  removal  of 
temptation,  normal  mental  conditions,  and  especially  by  cold  baths 
and  vigorous  physical  exercise,  and  avoidance  of  an  excessive  meat 
diet,  continence  may  not  only  become  possible,  but  easy.  Those  who 
witness  the  good  enects  of  athletic  sports  can  not  fail  to  appreciate 
that  here  is  a  good  field  in  which  to  expend  exuberant  animal  spirits, 
and  in  this  sense  "  public  playgrounds  "  are  a  strong  factor  in  the 
promotion  of  sexual  purity.  We  can  hardly  go  astray  if  we  follow 
Doctor  Parkes  in  advising  a  pure  young  man  to  make  his  home  after 
the  age  of  22  or  23,  and  thus  secure  himself  both  from  the  temptations 
and  expenses  of  bachelorhood.  Dr.  Howard  A.  Kelly  believes  that 
the  Christian  standard  is  the  solution  of  the  whole  problem  of  chas- 
tity. I  quite  agree  with  him,  provided  the  church  makes  an  endeavor 
to  combine  religious  and  social  work,  and  until  this  is  accomplished 
we  should  not  hide  the  evil  because  it  is  not  a  pleasant  subject  to  talk 
about. 

Suggestions  as  to  what  the  church  may  do  have  been  offered  in  a 
former  report,  see  page  106,  Industrial  Hygiene,  and  the  desirability 
of  social  settlements  in  connection  with  schools  and  churches  will  be 
emphasized  in  connection  with  the  drink  evil,  see  page  248. 

Among  the  sensible  recommendations  submitted  by  the  "  commit- 
tee of  fifteen  "  in  the  city  of  New  York  were,  first,  "  strenuous  efforts 
to  prevent,  in  the  tenement  houses,  the  overcrowding  which  is  the 
prolific  source  of  sexual  immorality.  *  *  *  Secondly,  the  fur- 
nishing, by  public  or  private  munificence,  of  purer  and  more  elevat- 
ing forms  of  amusements  to  supplant  the  attractions  of  the  low  dance 
halls,  theaters,  and  other  similar  places  of  entertainment  that  only 
serve  to  stimulate  sensuality  and  to  debase  the  taste.  The  pleasures 
of  the  people  need  to  be  looked  after  far  more  earnestly  than  has  been 
the  case  hitherto.  *  *  *  Thirdly,  whatever  can  be  done  to  im- 
prove the  material  conditions  of  the  wage-earning  class,  and  espe- 
cially of  young  wage-earning  women,  will  be  directly  in  line  with  the 
purpose  which  is  here  kept  in  view.  It  is  a  sad  and  humiliating 
admission  to  make,  at  the  opening  of  the  twentieth  century,  in  one 
of  the  greatest  centers  of  civilization  in  the  world,  that  in  numerous 
instances  it  is  not  passion  or  corrupt  inclination,  but  the  force  of 
actual  physical  want  that  impels  young  women  along  the  road  to 
ruin."  Referring  to  the  question  of  intimate  contact  in  tenement 
houses  as  a  predisposing  cause  to  prostitution,  it  is  a  matter  of 
satisfaction  to  record  that  both  General  Sternberg  and  the  writer 
realized  this  danger  when  they  urged,  in  1898,  the  adoption  of  model 
two-story  apartment  houses  with  separate  entrances  and  exits  for 
each  family  so  that  the  sanctity  of  the  home  might  be  preserved. 

STATE  METHODS. 

The  question  naturally  arises.  What  can  and  should  the  State  do  to 
prevent  the  moral,  social,  and  physical  ravages  of  these  diseases  ?  It 
must  be  confessed  that  the  measures  looking  to  the  inspection  and 
control  of  prostitutes  are  sadly  inadequate.  It  has  been  suggested  by 
German  authors  that  the  evil  might  be  materially  lessened  by  holding 
the  persons  who  knowingly  spread  venereal  diseases  responsible  for 
the  damages.  Indeed,  a  German  jurist  goes  so  far  as  to  advocate  the 
punishment  of  persons  who  neglect  to  seek  treatment  when  afflicted 


228  REPOBTS  OP  THE  PRESIDENT'S  HOMES  COMMISSION. 

with  sexual  diseases.  Apart  from  this  the  State  should  certainly 
insist  upon — 

First.  The  enforcement  of  laws  or  police  regulations  relating 
to  houses  of  ill-fame  and  to  the  sale  of  alcohol,  particularly  to 
minors.  A  closer  supervision  of  soliciting  in  streets  and  enticing 
females  under  a  fixed  age.  There  is  certainly  no  good  reason  Avhy  the 
terrible  temptations  which  greet  our  young  men  and  women  on  every 
street  and  in  many  public  places  should  not  be  removed.  A  well- 
trained  police  force  will  have  no  difficulty  in  recognizing  and  ban- 
ishing the  solicitors,  both  male  and  female,  from  the  streets,  and  in 
cautioning  young  men,  especially  minors,  of  the  dangers  in  the  red 
light  districts. 

Second.  Health  boards  can  also  recommend  the  enactment  of  laws 
for  the  prevention  of  syphilis,  acquired  in  an  extra  genital  way,  by 
regulating  the  profession  of  barbers,  chiropodists,  and  manicurists, 
and  requiring  a  special  examination  of  wet  nurses,  cigar  makers,  and 
glass  blowers.  Apart  from  the  real  dangers  from  these  sources,  the 
educational  effects  of  such  ordinances  will  be  beneficial. 

Third.  Health  boards  should  also  exert  their  influence  toward 
securing  adequate  facilities  for  the  treatment  of  indigent  patients. 

In  northern  Europe,  where  venereal  diseases  are  reportable  and 
treatment  is  within  the  reach  of  all  classes,  these  diseases,  according 
to  Weiss,  have  greatly  diminished,  but  here,  as  Bulkley  puts  it, 
"  ignored  through  ignorance,  neglected  through  negligence  of  our 
duty,  so  ostracised  and  outclassed,  venereal  diseases,  through  false 
shame,  concealment,  prejudice,  carry  on  their  slaughter  unhampered, 
unchecked,  and  undisturbed,  devastating  coming  generations  and 
ruining  the  present  one." 

Fourth.  Health  boards  may  cooperate  with  the  profession  and 
dispensaries  by  printing,  for  distribution,  leaflets  stating  the  nature 
of  the  diseases,  the  manner  in  which  they  are  contracted,  and  the 
ways  in  which  they  can  be  transmitted  to  other  persons,  and  by  the 
encouragement  of  a  general  educational  campaign  in  which  sexual 
purity,  respect  for  women,  and  the  possibility  of  physiological  conti- 
nence should  be  inculcated.  The  evil  and  far-reaching  consequences 
of  impure  and  unlawful  gratification  should  be  clearly  pointed  out. 

In  conclusion,  a  word  of  caution  is  necessary  to  impress  upon  the 
victims  of  sexual  diseases  the  utter  uselessness  of  securing  treatment 
with  various  advertised  cures.  As  very  properly  said  by  Mr.  Samuel 
Adams  Hopkins  in  Collier's  Weekly,  September  22,  1906 : 

All  this  class  of  practitioners  are  frauds  and  swindlers.  Many  of  them 
are  ex-criminals  in  other  fields.  "  The  old  doctors,"  the  "  physicians'  insti- 
tutes," the  "medical  councils,"  and  the  "quick  cures"  are  all  equally  to  be 
shunned.  Blackmail  is  the  underlying  principle  of  this  business.  These  treat- 
ments can  not  cure;  ten  to  one  they  only  aggravate  the  disease  and  render 
it  dangerous  or  even  deadly.  But  once  they  have  a  man  in  their  clutches  they 
need  not  help  him  in  order  to  get  his  money.  If  he  demurs  at  their  charges, 
a  threat  to  expose  the  nature  of  his  ailment  to  his  family  or  employers  is 
enough.  *  ♦  *  Every  advertisement  of  private  diseases  or  "  men's  special- 
ists" ought  to  be  a  danger  signal  pointing  not  only  to  wasted  money,  shame, 
and  misery,  but  often  to  invalidism  and  a  dreadful  form  of  death,  where  in  90 
per  cent  of  cases  reputable  treatment  would  have  brought  the  patient  through. 

In  some  localities  it  is  against  the  law  to  publish  advertisements  of  this 
class.  Pennsylvania  has  such  a  law,  but  it  is  a  dead  letter.  St.  Louis  is 
attempting  to  enforce  its  Illegal  advertising  ordinance,  and  the  St.  Louis  news- 
papers are  fighting  to  save  themselves  the  dollars  tainted  with  unspeakable 
filth. 


EEPOBTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  229 

Chapter  VIIL 

THE    TOBACCO    HABIT. 

In  view  of  the  fact  that  our  sociological  study  of  1,217  families  in 
this  city  shows  an  average  annual  expenditure  of  $12.19  for  each 
family,  which  at  a  conservative  estimate  would  amount  to  $239,655,- 
000  for  the  annual  tobacco  bill  in  the  United  States,  it  is  important 
to  consider  the  effects  of  tobacco  on  the  system. 

Tobacco  owes  its  general  effects  to  the  presence  of  toxic  alkaloids 
known  as  nicotine,  nicotianin,  and  the  "  pyridin  bases  "  which  are 
formed  during  smoking.  Syrian  and  Havana  tobacco  contain  little 
or  no  nicotine,  while  the  common  grades  contain  from  3  to  4  per  cent. 
Nicotine  is  a  poison  which  produces  a  local  irritation  of  the  digestive 
tract,  nausea,  and  diarrhea.  In  some  instances  there  may  be  dizzi- 
ness, weakness,  restlessness,  depressed  action  of  the  heart,  and  convul- 
sions. Strangely  enough,  man  becomes  accustomed  to  these  effects  and 
may  even  experience  an  agreeable  excitation  of  the  nervous  system, 
characterized  by  increased  mental  and  physical  elasticity.  There  is 
nothing  to  justify  the  assumption,  however,  that  the  use  of  tobacco  is 
free  from  danger.  Professor  Seaver's  observations  on  Yale  students 
appear  to  show  that  nonsmokers  made  the  best  physical  gains  in 
weight,  chest  measure,  and  lung  capacity,  and  that  out  of  every  100  of 
the  best  students  only  5  were  smokers,  while  95  were  not  smokers.  His 
data  were  apparently  so  convincing  that  Japan,  ever  ready  to  profit 
by  the  experience  of  other  nations,  enacted  in  1900  a  law  prohibiting 
the  smoking  of  tobacco  by  persons  under  the  age  of  twenty — an 
example  well  worthy  of  emulation.  Dr.  A.  A.  WoodhuU,  U.  S. 
Army,  holds  that  cigarette  smoking  by  the  young  is  harmful,  as  it 
arrests  the  natural  elimination  of  waste  and  hinders  the  utilization 
of  fresh  material.  This  explains  the  fact  that  the  stature  of  youths 
who  use  it  is  less  than  those  who  do  not  use  it. 

The  bad  effects  of  tobacco  may  be  summarized  as  follows :  Tobacco 
smoke  contaminates  the  air  of  rooms  with  coal  gas  and  other  prod- 
ucts of  combustion.  According  to  the  London  Lancet,*  1  ounce  of 
tobacco  yields  from  1  to  5  pints  of  carbon  monoxide  or  coal  gas, 
which,  when  inhaled,  is  a  blood  poison.  In  many  instances  tobacco 
in  any  form  produces  a  chronic  inflammation  of  the  throat  and  stom- 
ach, which  disappears  after  the  removal  of  the  cause.  The  excessive 
use  of  tobacco  produces  a  chronic  form  of  nicotine  poisoning,  with 
impairment  of  vision,  nervous  irritability  or  exhaustion,  a  predispo- 
sition to  neuralgia,  and  a  peculiar  affection  of  the  heart,  described  by 
Professor  Da  Costa  as  the  tobacco  heart,  characterized  by  irregu- 
larity of  the  heart  sounds,  accelerated  action  and  weakness  of  the 
cardiac  muscles.  Chewing  of  tobacco  is  even  more  to  be  deprecated 
than  smoking,  as  the  injurious  elements  are  dissolved  by  the  saliva 
and  not  infrequently  swallowed.  Doctor  Woodhull  points  out  that 
cigarette  smoking  by  the  young  develops  a  greater  tendency  to  acquire 
an  appetite  for  alcoholic  liquors,  premature  puberty  is  induced,  in- 
creasing the  sexual  propensity  and  leading  to  improper  sexual  prac- 
tices.   There  is  a  consensus  of  opinion  among  educators  that  the  use 

«  The  Lancet,  London,  1908,  CLXV. 


230  REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

of  tobacco  dulls  the  memory  and  intellect.  When  a  promising  pupil 
in  a  public  school  begins  to  decline  in  his  work  it  is  almost  certainly 
found  that  he  has  begun  the  use  of  cigarettes. 

On  the  whole  we  may  conclude  that  the  use  of  tobacco  is  not  a 
physiological  necessity,  and  its  abuse,  like  that  of  other  nerve  stimu- 
lants, is  doubtless  a  fruitful  cause  of  a  breakdown.  It  is  especially 
harmful  in  nervous  subjects  and  those  of  insufficient  will  power 
properly  to  restrict  its  use.  A  German  authority  maintains,  and  no 
doubt  correctly,  that  the  danger  is  greater  from  smoking  cigarettes, 
because  of  the  ease  with  which  the  smoke  is  inhaled.  In  any  event, 
the  practice  of  inhaling  the  smoke  into  the  lungs,  or  smoking  before 
breakfast,  is  a  bad  one.  Pipes,  cigar  or  cigarette  holders,  and  the 
mouth  should  be  kept  clean.  Symptoms  of  shortness  of  breath, 
obscure  pains  around  the  heart  and  nervous  irritability  are  indica- 
tions to  reduce  or  stop  the  habit  altogether. 


Chapter  IX. 

THE  ALCOHOL  QUESTION. 

In  our  sociological  survey  of  1,217  families  in  this  city  we  found 
the  average  expenditure  for  alcoholic  beverages  to  be  $16.14  per  an- 
num. In  view  of  the  importance  of  the  subject  from  an  economic, 
social,  and  sanitary  point  of  view,  a-  study  of  the  alcohol  question 
seems  very  desirable.  Before  doing  so  it  will  be  well  to  refer  briefly 
to  different  alcoholic  beverages  in  most  common  use. 

FERMENTED  LIQUORS    (wINe). 

Among  the  oldest  and  best  known  of  alcoholic  beverages  is  wine, 
which  is  obtained  from  the  fermented  juice  of  grapes.  The  juice  con- 
tains water,  proteids,  grape  sugar,  levulose,  inosite,  pectins,  tartaric 
and  malic  acids  and  their  salts;  also  small  quantities  of  mineral 
salts  (sulphates  and  chlorides),  coloring  matter,  and  tannic  acid. 
In  off  years  malic  acid  predominates  and  there  is  a  deficiency  of 
sugar.  The  quality  of  the  juice  and  the  resulting  wines  depend 
upon  the  character  of  the  grape  (soil,  climate,  ripening  process)  and 
many  other  factors  in  the  preparation  of  the  must. 

If  a  white  wine  is  desired  the  skins  and  stems  of  the  grape  are  re- 
moved, while  for  colored  wines  they  are  permitted  to  remain;  the 
blue  and  yellow  pigments  during  fermentation  and  under  the  influ- 
ence of  free  acids  turn  red. 

Fermentation  of  the  grape  juice  is  usually  carried  on  at  a  tempera- 
ture between  60°  and  75°  F.  and  is  the  result  of  a  natural  ferment 
or  yeast  plant  found  on  the  skin  of  the  grape.  During  fermentation 
the  proteids  in  the  must  are  to  a  great  extent  used  up  in  the  forma- 
tion of  yeast  cells  and  the  grape  sugar  and  part  of  the  levulose  are 
split  up  into  alcohol  and  carbonic  acid.  The  inosite  remains  un- 
changed, the  pectous  matter  is  changed,  and  a  portion  of  the  salts 
are  percipitated  in  the  form  of  cream  of  tartar.  In  addition,  gly- 
cerin and  various  aromatic  ethers,  which  impart  to  the  wine  its  flavor, 
and  small  quantities  of  the  higher  alcohols  and  free  organic  acids 
are  formed.    The  resulting  wine  may  be  said  to  contain,  apart  from 


EEPOBTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  231 

water,  alcohol  and  carbonic  acid,  also  small  quantities  of  proteids, 
inbsite,  free  malic,  tartaric  and  succinic  acid,  salts,  glycerin,  and 
aromatic  ethers,  and  in  the  case  of  grapes  fermented  with  their  skins 
also  tannic  acid  and  coloring  matter. 

The  lighter  wines  of  this  and  other  countries,  viz,  the  Bordeaux, 
Burgundies,  Rhine,  and  Moselle  wines,  hock,  sauternes,  clarets,  and 
champagnes  usually  contain  from  9  to  15  per  cent  of  alcohol  by  vol- 
ume. The  fortified  or  stronger  wines  like  port,  sherry,  tokay,  etc., 
contain  from  16  to  27  per  cent  of  alcohol.  The  amount  of  sugar 
varies  from  0  in  dry  wines  to  26  per  cent  in  the  sweet  wines.  The 
natural  wines  contain  little  or  no  carbonic  acid  as  most  of  it  escapes 
during  fermentation.  The  effervescent  wines  like  champagne  are  the 
product  of  a  second  fermentation  in  the  bottle,  sugar  and  flavoring 
extracts  having  been  added  for  the  purpose. 

The  dietetic  effects  of  wine  depend  entirely  upon  the  amount  of  al- 
cohol present.  Dry  wines  usually  promote  peristaltic  action  and  act 
upon  the  kidneys,  the  red  wines  commonly  retard  the  movements  of 
the  bowels  which  is  due  to  the  astringent  effects  of  tannin. 

Cheap  wines  are  frequently  made  from  other  fruits  and  even  the 
natural  wines  have  been  subject  to  various  forms  of  adulteration, 
such  as  the  addition  of  sugar,  glycerin,  various  ethers,  logwood  and 
other  coloring  agents,  like  malvey  leaves,  red  beets,  carmine,  fuchsin, 
and  other  analin  colors. 

Unfortunately  the  manufacture  of  artificial  wines  appears  to  be 
everywhere  extending.  Some  years  ago  Petiot  considered  it  perfectly 
legitimate  to  extract  repeatedly  the  skin  and  seeds  of  grapes  with  a 
solution  of  sugar,  which  was  then  permitted  to  undergo  the  usual 
fermentation,  the  percentage  of  alcohol  varying  with  the  amount  of 
sugar  present.  Harrington  informs  us  that  an  artificial  wine  known 
as  "piquette,"  and  of  which  over  50,000,000  gallons  were  made  in 
France  in  1898,  is  made  as  follows :  "  To  each  gallon  of  water  used 
are  added  1  pound  of  raisins  and  1  of  dried  apples;  the  mixture  is 
placed  in  an  open  vessel  and  allowed  to  stand  three  days.  It  is  then 
bottled  with  one-half  teaspoonful  of  sugar  and  a  small  piece  of  cinna- 
mon in  each  bottle.  It  is  said  to  be  'a  pleasant  and  harmless 
beverage.' "  Indeed,  so  serious  and  widespread  has  become  the  manu- 
facture of  artificial  wine  in  France  that  the  wine  growers  in  1907 
revolted  and  demanded  adequate  legislative  protection.  Harrington 
and  Wiley  furnish  other  examples  of  the  methods  followed  by  those 
engaged  in  this  nefarious  trade: 

Port. — Cider,  30  gallons;  alcohol,  5  gallons;  sirup,  4  gallons;  kino,  one-half 
pound;  tartaric  acid,  one-quarter  pound;  port-wine  flavor,  6  ounces. 

White  wine. — Dissolve  25  pounds  of  grape  sugar  and  1  of  tartaric  acid  in 
25  quarts  of  hot  water;  add  75  quarts  of  cold  water  and  50  pounds  of  grape 
pulp,  stir,  cover,  let  ferment  for  four  or  five  days  and  strain. 

Claret. — California  hock,  40  gallons;  extract  of  kino,  8  ounces;  essence  of 
malvey  flower,  8  ounces. 

These  samples  are  given  to  show  how  easy  it  is  to  deceive  the 
average  customer,  who  often  pays  a  high  price  for  beverages  assumed 
to  possess  food  values  or  medicinal  properties. 

FRUrr    WINES. 

Homemade  wines  are  often  made  from  the  fermented  juice  of 
apples,  pears,  currants,  gooseberries,  and  oranges ;  they  contain  pretty 


232  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

much  the  same  ingredients,  except  inosite,  as  grape  wine.  The  per- 
centage of  alcohol  is,  however,  less,  on  account  of  the  deficiency  of 
sugar,  unless  sugar  has  been  added,  which  is  often  done. 

Apple  or  pear  cider  usually  contains  from  4J  to  6  per  cent  of  alco- 
hol. According  to  Parkes  such  wines  are  sometimes  manufactured 
or  stored  in  earthenware  vessels,  coated  inside  with  litharge  glaze, 
which  readily  gives  up  larg;e  quantities  of  lead  to  acid  liquids  and  is 
thus  productive  of  lead  poisoning.  If  the  air  is  not  absolutely  ex- 
cluded from  all  kinds  of  wine,  acetous  fermentation  ensues,  and  the 
liquid  is  transformed  into  vinegar.  The  effects  of  home-made  wines 
are  moderately  stimulating,  and  slightly  laxative  and  diuretic  on 
account  of  the  free  organic  acids  contained  therein.  It  is  also  held 
that  their  habitual  use  favors  the  formation  of  gravel  and  stone  in 
the  bladder  and  chronic  inflammation  of  the  urinary  passages. 

BEERS. 

Beer  is  a  very  ancient  beverage,  having  been  used  by  the  Egyptians 
over  two  thousand  years  ago.  It  was  introduced  into  Germany 
during  the  twelfth  century  and  for  a  long  time  the  art  of  brewing 
was  largely  confined  to  the  cloistered  monks.  Pure  beer  is  manu- 
factured from  malt,  hops,  and  water.  In  the  first  place,  clean 
barley  is  steeped  in  hard  water  and  is  then  allowed  to  sprout 
in  heaps,  which  are  spread  out  when  the  germination  has  reached 
the  requisite  stage.  During  this  process  diastase  develops  which 
converts  the  starch  into  dextrin  and  maltose,  and  the  insoluble  albu- 
minous matter  is  rendered  soluble.  Further  germination  is  prevented 
by  first  drying  and  then  parching  the  malt  at  a  temperature  of  125° 
to  180°;  this  also  develops  color  and  flavor.  The  malt  is  then 
screened  for  the  removal  of  the  sprouts  and,  after  being  crushed, 
is  steeped  in  water  at  a  temperature  of  160°  F.,  which  has  the  effect 
of  converting  the  balance  of  starch  in  the  wort  into  maltose.  The 
resulting  infusion,  after  the  addition  of  hops,  is  now  boiled  for  a 
couple  of  hours,  during  which  about  one-third  of  the  bitter  princi- 
ples of  the  hops  are  taken  up,  the  coagulable  proteids  are  separated 
and  all  existing  micro-organisms  are  destroyed.  The  decoction  is 
then  rapidly  cooled  in  tanks  and  transferred  into  vats,  where,  after 
the  addition  of  yeast,  it  is  allowed  to  ferment  at  a  temperature  of 
G0°  to  66°  F. ;  during  this  process  the  maltose  is  split  up  into  alcohol 
and  carbonic  acid.  When  fermentation  has  gone  far  enough  the 
yeast  is  removed  and  the  beer  is  run  into  casks.  Good  beer,  apart 
from  alcohol,  carbonic  acid,  glycerin,  succinic  acid,  also  contains 
some  proteids,  sugar,  malt  extracts,  salts,  and  bitter  principles.  The 
percentage  of  alcohol  varies  from  3  per  cent  in  the  lighter  kinds  to 
6  or  7  per  cent  in  ale  and  porter.  In  the  28  specimens  exan  ined 
by  Mr.  C.  A.  Crampton,  of  the  Internal  Revenue  Office^  the  amount 
of  alcohol  averaged  4.63  per  cent  by  weight  or  5.79  per  cent  by 
volume. 

The  so-called  "  Weiss  beer  "  is  made  from  a  mixture  of  barley  and 
wheat  malt  and  usually  contains  more  carbonic  acid  and  yeast  par- 
ticles and  less  alcohol  than  ordinary  beer.  Porter,  ale,  and  bock  beer 
are  made  from  a  stronger  wort  and*^  hence  contain  more  alcohol.  The 
chemical  analysis  shows  that  beer  is  not  only  a  beverage,  but  also  a 
foodstuff,  because  2  liters  of  beer  contain  about  10  grams  of  proteids 


EEPORTS   OP   THE  PBESIDENt's  HOMES   COMMISSION.  283 

and  100  grams  of  carbohydrates,  or  nearly  one-tenth  of  the  protein 
ration,  and  one-fifth  of  the  daily  requirements  of  carbohydrates. 

In  recent  years  beer  has  been  known  to  be  adulterated  by  the  em- 
ployment of  glucose  and  invert  sugars  obtained  by  the  action  of  dilute 
sulphuric  acid  upon  rice  and  com. 

This  sophistication  affects  not  only  the  nutritive  value  of  the  beer 
by  a  deficiency  of  the  proteids,  but  may  also  be  a  source  of  arsenical 
poisoning,  if  the  sulphuric  acid  happens  to  be  derived  from  arseix.cal 
pyrites.  Such  an  instance  occurred  in  1900  at  Manchester  and  Sal- 
ford  in  the  northwest  of  England,  where  over  3,000  consumers  of  beer 
developed  symptoms  of  arsenical  poisoning,  such  as  paralysis  and 
wasting  of  certain  muscles,  functional  disturbances  of  certain  sensory 
nerves,  with  36  fatal  cases  from  peripheral  neuritis.  Specimens  of  the 
glucose  showed  from  0.02  to  0.05  per  cent  of  arsenious  oxide  and  the 
beers  made  from  it  contained  from  0.10  to  1.60  grains  of  arsenic  per 
gallon.  It  is  gratifying  to  note  that  adulterated  beer  is  quite  uncom- 
mon in  this  countTj,  as  none  of  the  476  samples  examined  in  the  State 
of  New  York  contained  hop  substitutes.  The  effects  of  beer  and  wine 
depend  upon  their  purity,  the  quantity  consumed,  and  the  suscep- 
tibility of  the  individual.  Quite  a  number  of  authors  believe  that 
these  beverages,  consumed  in  moderation,  say  from  one-quarter  to 
one-half  liter  of  wine  or  from  one-half  to  1  liter  of  beer  during 
twenty-four  hours,  in  otherwise  normal  persons,  will  have  no  inju- 
rious effects,  and  may  even  possess  certain  advantages,  such  as  aiding 
digestion  by  promoting  the  flow  of  digestive  juices,  while  the  bitter 
principles  of  hops  possess  certain  tonic  properties.  On  the  other 
hand  Buchner,  Ogata,  and  others  claim  that  beer  retards  digestion, 
and  all  agree  that  if  taken  habitually  in  excess,  both  beer  and  wine, 
in  the  language  of  Parkes,  "  lead  to  the  storage  up  of  superfluous  fat 
in  the  tissues,  and  they  interfere  with  the  proper  elimination  of  effete 
matter;  imperfect  oxidation  leads  to  an  excessive  formation  of  uric 
acid,  and  the  plethoric  and  gouty  habit  are  produced,  eventually  tend- 
ing to  palpable  disease." 

BRANDY. 

Brandy,  the  strongest  alcoholic  drink,  is  derived  from  the  distilla- 
tion of  wine,  but  as  commonly  sold  it  is  for  the  most  part  a  mixture 
"  of  varying  amounts  of  spirits  from  the  distillation  of  com  grain 
spirits,  etc."  Apart  from  water  it  contains  55  to  65  per  cent  of  alcohol 
by  volume,  or  39  to  47  per  cent  by  weight,  in  which  are  held  aromatic 
ethers,  also  traces  of  tannin,  coloring  matter,  and  various  secondary 
products,  including  aldehydes,  furfural  and  higher  alcohols.  Har- 
rington gives  a  number  of  examples  showing  how  fictitious  brandy  is 
made,  of  which  the  following  is  reproduced : 

Boil  5  ounces  of  raisins  and  6  of  St.  John's  bread  in  water,  filter  and  make  up 
to  10  quarts;  mix  this  with  20  quarts  of  alcohol,  one-half  ounce  of  essence  of 
violet  flowers,  and  10  ounces  of  brandy  essence. 

RUM    AND   ARRACK. 

Rum  is  distilled  from  fermented  molasses,  and  arrack  from  fer- 
mented rice  or  cocoanuts;  they  contain  from  55  to  65  per  cent  of 
alcohol  by  volume  and  more  or  less  of  the  objectionable  fusel  oil  and, 
like  other  strong  drink,  are  frequently  adulterated. 


234  REPORTS   OF    THE  PRESIDENT'S   HOMES   COMMISSION. 

WHISKY. 

Whisky  is  made  by  distillation  of  malted  grain,  especially  rye,  corn, 
and  wheat,  although  barley,  oats,  and  potatoes  are  sometimes  used. 
The  mash  for  Scotch  whisky  consists  of  2  parts  of  malt,  7  of  barley, 
and  1  each  of  oats  and  rye;  the  mash  for  Irish  whisky  is  the  same 
with  the  exception  of  the  rye;  the  peculiar  smoky  taste  of  these 
whiskies  is  due  to  the  cresote  products  evolved  in  peat  and  turf  fires 
over  which  the  malt  is  dried.  Good  Bourbon  whisl^  has  an  agree- 
able flavor,  the  mash  being  a  mixture  of  corn  and  rye.  All  new 
whiskies,  in  addition  to  about  45  per  cent  of  ethylic  alcohol,  contain 
amylic  alcohol  or  fusel  oil  and  other  impure  alcohols.  These  im- 
purities are  very  irritating  to  the  mucous  membranes  of  the  throat 
and  stomach  and  produce  rapid  intoxication;  the  fusel  oil  is  also 
responsible  for  the  headache,  nausea,  and  general  depression  so  often 
observed  after  the  consumption  of  impure  liquors.  The  amount  of 
toxicity  of  the  fusel  oil  depends  upon  the  character  of  the  raw  mate- 
rial, it  being  greatest  when  derived  from  potatoes  and  least  when 
obtained  from  grapes.  The  aldehydes  can  be  removed  by  redistilla- 
tion and  the  fusel  oil  by  charcoal  or  a  fractionating  patent  still. 
The  fine  spirit  secured  by  rectification  contains  from  72  to  90  per 
cent  of  absolute  alcohol  and  only  traces  of  the  impurities  referred 
to,  while  ordinary  whisky  contains  from  35  to  50  per  cent  by  volume 
of  alcohol  and  almost  always  some  of  the  toxic  principles.  It  is  a 
familiar  but  true  saying  that  whisky  improves  with  age  in  taste 
and  flavor.  This  is  due  to  the  fact  that  the  constituents  of  fusel  oil 
are  converted  into  nontoxic  aromatic  ethers  which  impart  the  agree- 
able flavor  to  aged  whiskies  and  brandies  and  also  constitute,  with 
other  compounds,  the  bouquet  in  different  wines.  The  new  and  cheap 
grades  of  whisky  are  decidedly  injurious  to  health  and  when  fusel 
oil  is  present  to  the  extent  of  1  part  per  1,000  it  is  unfit  for  use. 

There  is  abundant  evidence  to  show  that  whisky  is  frequently 
manufactured  from  alcohol,  water,  and  various  flavoring  compounds, 
of  which  the  following  example  is  given  by  Harrington : 

Scotch  whisky. — Alcohol,  46  gallons;  genuine  Scotch,  8  gallons;  water,  18 
gallons;  ale,  1  gallon;  cresote,  5  drops  in  2  ounces  of  acetic  acid;  pelargonic 
ether,  1  ounce;  honey,  3  pounds. 

The  writer  fears  that  in  the  manufacture  of  fictitious  whiskies 
methyl  or  wood  alcohol  is  also  used  on  account  of  its  cheapness ;  this, 
when  employed  as  an  intoxicant,  has  been  known  to  produce  total 
blindness. 

THE    nation's   drink   BILL.<» 

As  the  nation  grows  in  population  and  wealth,  so  does  its  expendi- 
tures for  stimulating  beverages.  This  is  the  more  surprising  in  view 
of  the  warfare  waged  against  the  saloon  and  the  milder  beverages. 
The  per  capita  consumption  of  spirituous  liquors  for  the  year  ending 
June  30,  1907,  is  the  highest  on  record,  reaching  23.63  gallons  per 
capita,  an  increase  over  1906  of  1.27  gallons. 

oThls  article  appeared  in  the  American  Grocer,  May  27,  1908,  and  is  repro- 
duced by  permission  of  the  editor. 


REPORTS   OF    THE  PRESIDENT'S   HOMES   COMMISSION.  235 

The  advance  in  the  consumption  of  distilled  spirits  from  1.52 
gallons  per  capita  in  1906  to  1.63  gallons  in  1907  is  more  notable  than 
an  increase  of  0.12  gallon  in  the  use  of  wine  and  a  rise  of  1.04  gallons 
in  beer. 

The  year  was  one  of  phenomenal  prosperity,  and  this  may  account 
for  the  increase  in  expenditure  for  stimulants,  which  was  quite  as 
marked  for  coifee  and  cocoa  as  for  alcoholic  drinks.  The  use  of  tea 
seems  to  have  declined  considerably,  as  it  falls  below  the  yearly 
average  for  five  years. 

A  gain  of  1,600,806  in  population  will  not  account  for  the  increased 
use  of  stimulating  beverages.  Possibly  extensive  advertising  is  re- 
sponsible for  no  small  share  of  the  increase,  which  seemingly  goes 
forward  in  spite  of  all  efforts  to  check  the  sale  of  intoxicating  bev- 
erages and  to  kill  the  demand  for  coffee.  "  There's  a  reason,"  but  it 
baffles  solution.  There  are  many  theories  or  opinions,  but  the  finding 
of  a  reasonable  check  to  the  use  of  spirituous  beverages  seems  as  far 
away  as  ever.    Legislation  does  not  seem  to  curb  the  curse  of  drink. 

RETAIL  COST  OF  ALL  BEVEEAGES. 

The  various  estimates  of  cost,  presented  by  the  American  Grocer, 
compiled,  so  far  as  quantity  is  concerned,  from  the  report  of  the 
United  States  Bureau  of  Statistics,  shows  that  the  average  annual 
cost  of  alcoholic  and  nonalcoholic  stimulants  in  the  United  States, 
1905-1907,  was  as  follows : 

Alcoholic  drinks. $1,  466,  584,  327 

Nonalcoholic  stimulants : 

Coffee $161,  598,  437 

Tea 41,  902,  680 

Cocoa 10,  000,  000 

213,  501, 117 

Total,  1907. 1,  698,  085,  444 

1906 1,  660,  489,  520 

1905 1,  548,  708,  307 

1904. 1,  498,  622,  715 

,  1903- 1,  451,  633,  379 

Total  drink  bill,  five  years,  1903-1907 7,  857,  548,  365 

Average  annual  drink  bill,  1903-1907 1,  571,  509,  673 

The  above  represents  a  per  capita  expenditure  for  beverages  in  1907 
of  $19.74  for  the  85,817,239  inhabitants  of  the  United  States,  or 
$98.70  for  each  family  of  five.  Yearly  average  for  five  years,  $19,  or 
$95  per  family. 

The  quantities  of  the  four  leading  beverages  consumed  annually  for 
three  years,  1905-1907,  as  estimated  by  the  American  Grocer,  were 
as  follows : 

Gallons. 

Beer 1,  686,  667,  659 

Coffee 1,  615,  984,  370 

Tea 558,500,000 

Spirits  and  wines 156,029,818 


236  REPOETS  OP   THE  PRESIDENT'S  HOMES  COMMISSION. 

PEB    CAPITA    CONSUMPTION    ALCOHOLIC    DKINKS. 

The  following  table  shows  the  annual  per  capita  consumption  of 
liquors  in  the  United  States  for  ten  years : 


Year  ending  June  30— 

Spirits. 

Wines. 

Beer. 

Total. 

1898 

Gallons. 
1.12 
1.18 
1.28 
1.33 
1.36 
1.46 
1.48 
1.45 
1.52 
1.63 

Gallons. 
0.28 
.35 
.39 
.37 
.63 
.48 
.53 
.42 
.55 
.67 

Gallons. 
15.96 
15.28 
16.01 
16.20 
17.49 
18.04 
18.28 
18.50 
20.19 
21.23 

Gallons. 
17  36 

1899 

16  81 

1900 

17.68 

1901 

17  90 

1902. 

19  48 

1903 

19  98 

1904 

20  35 

1905 

20  38 

1906 

22  26 

1907 

23  53 

TOTAL   ALCOHOLIC   DRINK  BILL. 

Bringing  together  the  quantities  of  liquors  consumed,  estimated  at 
the  retail  cost  on  the  basis  of  previous  reports,  it  is  shown  that  the 
American  people  spent  for  alcoholic  stimulants  for  the  year  ending 
June  30,  1907: 

Beer $843,  333,  829 

Whisky  (exclusive  of  quantity  used  in  arts) 118,456,091 

Grand  total,  1907 1,466,544,327 

1906 1,  450,  855,  448 

1905 1,  325,  439,  074 

1904 1,  277,  727, 190 

1903 1,  242,  943, 118 

1902 1, 172,  565,  235 

1901 1,  094,  644, 155 

1900 1,  059,  563,  787 

1899 973,  589,  080 

LIQUOB  AND   TOBACCO  TAX. 

The  total  revenue  of  the  United  States  Government  in  1907  from 
spirituous  and  malt  liquors,  and  from  tobacco,  the  ally  of  liquor,  was 
$247,458,911,  or  $2.88  per  capita,  equal  to  $14.40  tax  on  every  family. 

CONCLUSION. 


We  must  leave  to  students  of  social  economy  the  question  of  a  great 
nation  spending  an  average  of  over  one  and  one-half  billions  annually 
for  stimulating  beverages ;  a  sum  about  as  great  as  the  appropriations 
of  the  Congress  for  a  session.  Nearly  double  as  much  per  capita  is 
spent  for  drink  as  is  spent  for  the  maintenance  of  public  schools.  It 
nearly  equals  the  value  of  exports  of  merchandise  per  capita.  It  is 
double  the  amount  of  the  public  debt.  It  is  more  than  the  farm  value 
of  the  corn  crop,  which  exceeds  2,500,000,000  bushels ;  three  times  the 
value  of  the  wheat  grown ;  more  than  double  the  worth  of  the  cotton 
crop.  The  indirect  cost  is  beyond  estimate,  and  so  great  is  the  waste 
and  misery  created  that  States  are  fighting  the  evil  and  endeavoring 
to  banish  the  saloon  as  a  distributing  factor.  It  is  easily  the  fore- 
most question  of  the  day,  and  places  the  support  of  a  big  navy  or  an 
army  in  the  shade. 


KEPOBTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  237 

ALCOHOL  AS  A   POODSTHBT. 

Professor  Liebig  was  perhaps  the  first  to  declare  that  alcohol  stands 
only  second  to  fat  as  a  respiratory  material,  but  wisely  added  that  the 
s  xme  effect  could  be  produced  in  the  body  by  means  of  saccharine  and 
farinaceous  articles  of  food  at  one-fourth  or  one-fifth  the  cost. 

Professor  Atwater,  in  order  to  determine  the  food  value  of  alcohol, 
substituted  for  a  portion  of  the  nonnitrogenous  food  a  quantity  of 
ethyl  alcohol  equivalent  in  energy  to  the  food  which  it  replaced — 2^ 
ounces  of  absolute  alcohol  per  day  in  six  doses — and  found  what  had 
been  taught  in  fact  by  Liebig  (1)  extremely  little  of  the  alcohol  was 
given  off  from  the  body  unconsumed  in  the  breath  or  otherwise — ^the 
alcohol  was  oxidized,  i.  e.,  burned  as  completely  as  bread,  meat,  and 
other  ordinary  foods  in  the  body  and  in  the  same  way;  (2)  in  the 
oxidation  all  of  the  potential  energy  of  the  alcohol  was  transformed 
into  heat  or  muscular  energy.  In  other  words,  the  body  transformed 
the  energy  of  the  alcohol  just  as  it  did  that  of  sugar,  starch,  and  fat. 
That  is,  whether  the  body  was  at  rest  or  at  work,  it  held  its  own  just 
as  well  when  alcohol  formed  a  part  of  the  diet  as  it  did  with  a  diet 
without  alcohol. 

These  experiments  clearly  demonstrate  the  food  value  of  alcohol, 
but  Atwater  wisely  adds  that  it  should  be  remembered  that  the  physi- 
ological action  of  alcohol  involves  much  besides  its  nutritive  effect. 
Its  "influence  on  the  circulatory  and  nervous  functions  is  especially 
important.    He  also  said : 

Whether  alcohol  is  to  be  called  a  food  or  not  depends  upon  the  definition  of 
the  food. 

The  writer  does  not  question,  the  scientific  deductions  made  from 
these  experiments,  but  objects  that  alcohol  should  be  considered  any- 
thing else  than  an  accessory,  to  be  used  with  extreme  precautions.- 
Professor  Atwater  has  told  us,  in  one  of  his  excellent  bulletins,  that 
"  the  most  healthful  food  is  that  which  is  best  fitted  to  the  wants  of 
the  user ;  the  cheapest  food  is  that  which  furnishes  the  largest  amount 
of  nutriment  at  the  least  cost,  and  the  best  food  is  that  which  is  both 
healthful  and  cheapest." 

PHYSIOLOGICAL   EFFECTS    OF    ALCOHOL. 

Absolute  alcohol,  on  account  of  its  affinity  for  water,  exerts  a  caustic 
effect  on  the  mucous  membranes.  When  properly  diluted,  it  is  rap- 
idly absorbed  and  speedily  oxidized.  It  is  a  stimulant  to  the  central 
nervous  system  and  the  sympatheticus  of  the  heart  and  produces  a 
feeling  of  exhilaration,  vivacity  of  the  mind,  accelerated  pulse,  and 
increased  muscular  activity.  Bunge  denies  these  properties,  and 
claims  that  its  primary  action  is  that  of  a  depressant,  and  that  its 
apparent  good  effects  are  simply  due  to  the  obtusing  influence  upon 
physical  and  mental  suffering.  But  this  is  scarcely  a  correct  assump- 
tion, as  there  are  individuals  in  whom  the  smallest  doses  produce 
palpitation  of  the  heart,  throbbing  of  the  carotids,  and  great  mental 
activity.  He  also  claims  that  alcohol  does  not  produce  renewed  vigor 
in  tired  individuals,  but  simply  obtuses  the  feeling  of  exhaustion. 
Dr.  Henry  Smith  Williams,  discussing  the  relation  of  alcohol  to 
muscular  work,  states  that  alcohol  does  not  increase  the  capacity  to 


238  REPORTS  OP  THE  PRESIDENT'S  HOMES  COMMISSION. 

do  muscular  work,  but  distinctly  decreases  it.  (McClure's  Magazine, 
October,  1908.)  Atwater's  experiments  conclusively  show  that  in  the 
oxidation  of  alcohol  in  the  system  all  the  potential  energy  is  trans- 
formed into  heat  or  muscular  energy;  and  there  is  certainly  reason 
for  believing  that  it  is  also  a  stimulant.  How  else  can  we  explain 
the  action  o?  brandy  in  cases  of  heart  failure?  It  would  be  absurd 
to  talk  here  of  an  obtusing  or  stupefying  effect.  It  is  a  stimulant 
which,  like  other  agents  of  this  class,  is  followed  by  a  stage  of  de- 
pression. 

Alcohol,  in  moderate  and  diluted  doses,  evidently  stimulates  diges- 
tion, as  shown  by  its  beneficial  effects  after  a  hearty  meal;  but  large 
quantities  interfere  with  or  arrest  the  peptonizing  process,  and  fre- 
quently produce  acute  gastric  catarrh.  These  effects  are  liable  to  be 
observed,  when  present,  to  the  extent  of  10  per  cent  of  the  gastric 
contents.  Alcohol  also  exerts  a  marked  diuretic  effect,  which  is  be- 
lieved to  be  due  to  a  direct  irritation  of  the  renal  epithelium. 

PATHOLOGICAL  EFFECTS  OF  ALCOHOL. 

The  habitual  use  of  immoderate  doses  of  alcohol  can  not  fail  to  pro- 
duce serious  injury  to  mind  and  body.  One  of  the  most  constant 
effects  is  chronic  inflammation  of  the  stomach,  with  consequent  im- 
paired digestion  and  nutrition.  It  produces  fatty  degeneration  of  the- 
heart,  liver,  and  arterial  coats,  a  most  common  cause  of  apoplexy, 
probably  because  it  promotes  the  conversion  of  albuminoid  tissues  into 
fats.  The  connective  tissues  of  the  body  increase  in  amount  and  their 
subsequent  contraction  gives  rise  to  cirrhosis  (hardening  of  the 
liver),  Bright's  disease,  and  chronic  meningitis.  It  is  one  of  the 
most  fruitful  causes  of  insanity  and  affections  of  the  nervous  system — 
like  inflammation  of  the  nerves,  palsies,  epilepsy,  etc.  Doctor  Maca- 
tee's  investigation  shows  that  during  the  past  nine  years  9,510  patients 
were  treated  for  alcoholism  and  409  for  delirium  tremens  in  the  city 
hospitals  of  Washington,  the  majority  of  the  patients  at  public 
expense. 

It  is  a  lamentable  fact  that  while  the  mortality  from  the  so-called 
preventable  diseases  in  the  United  States  has  markedly  declined  in 
the  last  two  decades,  the  death  rate  from  Bright's  disease,  heart  dis- 
ease, dropsy,  apoplexy,  and  pneumonia  are  apparently  greater  than 
in  1890.  For  reasons  just  stated  we  may  well  pause  to  inquire 
whether  our  ever-increasing  "  national  drink  bill "  may  not  be  a  factor 
in  the  undue  prevalence  of  these  diseases,  as  also  in  the  increase  of 
insanity  and  nervous  disorders. 

ALCOHOL  INCREASES  THE  SUSCEPTIBILITY  TO  DISEASE. 

Professor  Hodge,  of  Clark  University,  in  1895  demonstrated  the 
injurious  effects  of  alcohol  upon  dogs.  The  more  recent  experiments 
of  Taavlaitmen,  cited  by  Babcock,"  apparently  show  that  in  dogs, 
rabbits,  guinea  pigs,  fowls,  and  pigeons  alcohol  distinctly  increases 
the  susceptibility  to  experimental  infection;  and  that  the  abnormal 
temperature  of  experimental  diseases  persists  longer  than  in  infected 
animals  that  do  not  receive  the  drug.    Dr.  Reid  Hunt,  of  the  Public 

•Preventive  Medicine,  p.  83. 


BEPOETS   OF   THE  PRESIDENT  S  HOMES   COMMISSION. 


239 


Health  and  Marine-Hospital  Service,  in  1906  conducted  a  similar 
line  of  experiments  and  arrived  at  the  same  conclusion.  Metchnikoff  « 
attributes  this  to  the  fact  that  alcohol  lowers  the  resistance  of  the 
white  corpuscles  of  the  blood,  which  are  the  natural  defenders  of  the 
body. 

Lanceraux  has  shown  that  in  2,192  cases  of  tuberculosis  studied  by 
him  over  one-half  were  confirmed  drunkards,  and  Guttstadt's  Sta- 
tistics ^  also  indicate  that  consumption  is  especially  common  among 
bartenders  and  brewers.  Indeed,  every  physician  knows  that  alcohol 
not  only  predisposes  to  tuberculosis,  pneumonia,  typhoid  fever,  and 
other  infectious  diseases,  but  also  that  these  diseases  are  more  fatal 
or  run  a  more  severe  course  in  alcoholic  subjects — probably  because 
of  the  impaired  digestive  functions  and  a  general  depraved  nutrition 
of  the  system,  with  consequent  diminished  power  of  resistance.  Apart 
from  the  diseases  already  referred  to,  alcohol  also  increases  the  ten- 
dency to  rheumatism  and  gout,  and  according  to  Babcock  "  there  is  a 
distinct  relationship  between  the  incidence  of  alcoholism,  insanity, 
venery,  and  crime." 

EFFECTS   OF   ALCOHOL   UPON    LONGEVITY. 

The  following  figures,  taken  from  Doctor  Ogle's  report  (Forty- 
fifth  annual  report  of  the  registrar-general  of  England),  show  the 
effect  of  intemperate  habits  in  shortening  life: 

Comparative  mortality  of  males  25  to  65  years  of  age. 


All  causes  complete. 


Mortality  figures 

Diseases  of  the  nervous  system 

Respiratory  system 

Urinary  system 

Liver  

Alcoholism 

Gout 


Innkeepers- 

All  males, 

publicans 

England 
and 

Brewers. 

spirit, 
wine, 

Wales. 

or  beer 
dealers. 

1,000 

1,361 

1,521 

119 

144 

200 

182 

236 

217 

41 

55 

83 

39 

96 

240 

10 

25 

55 

3 

9 

13 

Life-insurance  tables  based  upon  English  statistics  cited  by  Jewett 
(Town  and  City,  p.  87) : 

Average 
expecta- 
tion of 
Ufe. 

Moderate 
drinkers. 

Total 
abstainers. 

At  20  expect  to  live  to  be 

62 
65 
68 

35 

m 

5U 

64 

At  30  expect  to  live  to  be 

661 
R8 

At  40  expect  to  live  to  be 

EFFECTS   OF   ALCOHOL   UPON    MENTAL   AND    MORAL   FACULTIES. 

Perhaps  one  of  the  most  deplorable  effects  of  alcohol  is  that  it  pro- 
duces structural  changes  of  the  cells  of  the  brain  and  spinal  cord — a 

oThe  New  Hygiene,  p.  25. 


^  Klin.  Jahrbuch  f.  1904. 


240  REPOBTS  OF  THE  PRESIDENT'S  HOMES  COMMISSION. 

fruitful  cause  of  insanity — ^and  leads  to  a  mental  and  moral  deteriora- 
tion, characterized  by  the  loss  of  will  power,  blunted  moral  sensi- 
bilities, and  the  ruin  of  character;  and,  saddest  of  all,  these  effects  are 
often  transmitted  through  vulnerable  anatomical  elements  to  the 
offspring. 

A  curious  record  has  been  complied  by  Professor  Pellman  of  the 
University  of  Bonn.  It  relates  to  the  career  of  a  notorious  drunkard 
who  was  bom  in  1740  and  died  in  1800.  In  investigating  her  history 
her  descendants  were  found  to  have  numbered  834,  of  whom  709  have 
been  traced  from  their  youth.  Of  these,  7  were  convicted  of  murder, 
76  of  other  crimes,  142  were  professional  beggars,  64  lived  on  charity, 
and  181  women  of  the  family  led  disreputable  lives.  Further  inquiry, 
moreover,  showed  that  the  family  cost  the  German  Government  for 
maintenance  and  costs  in  the  courts,  almshouses,  and  prisons  no  less 
than  $1,250,000 — in  other  words,  just  a  fraction  under  $1,500  each. 
It  would  probably  be  difficult  to  find  a  more  remarkable  example  than 
this  of  the  evil  effects  of  the  drink  habit  and  the  transmission  of 
hereditary  defects. 

The  statistics  of  the  Elmira  Reformatory  for  1900  show  that  3,363 
of  the  9,344  convicts  had  drunken  ancestors  and  the  records  of  every 
police  court  reveal  the  startling  fact  that  about  60  per  cent  of  all 
sentences  are  imposed  for  drink.  Ninety-one  of  the  175  prisoners 
examined  by  Dr.  Paul  B.  Johnson  in  the  Washington  Workhouse  were 
sentenced  for  drunkenness  and  disorderly  conduct,  and  171  admitted 
the  use  of  alcohol,  most  of  them  to  excess.  Mr.  Boies  estimates  that 
the  share  of  alcohol  in  the  expense  of  crime  in  the  United  States  is 
$4.34  per  capita,  or  over  $420,000,000  per  annum  (Jewett,  p.  24-25). 

Professor  Demme's  statistics  of  10  temperate  and  10  intemperate 
families,  based  upon  ten  years'  study  and  observation,  are  also  of 
interest : 


Children 

Died  before  6  weeks  old 

IdlotB 

Stunted  in  growth 

Epilepsy 

Nervous  in  childhood,  but  cured 

Ordinary  good  health  in  childhood,  per  cent 


Temper- 

Drunkards' 

families. 

families. 

61 

67 

5 

25 

0 

6 

0 

5 

0 

6 

6 

0 

81.5 

17.6 

Moreover,  Von  Bunge  has  shown  that  the  daughters  of  alcoholic 
fathers  in  the  third  generation  are  usually  unable  to  nurse  their 
offsprings. 

ALCOHOL   AS   A   CAUSE   OF   ACCmENTS. 

Considerable  evidence  might  be  adduced  to  show  the  relationship  of 
alcohol  to  railroad  and  other  accidents.  Those  who  are  familiar  with 
the  effects  of  intoxicants  need  no  argument  in  favor  of  sobriety.  All 
business  men  and  railroad  corporations  realize  the  value  of  sober  hab- 
its among  their  employees,  and  quite  a  number  insist  upon  total 
abstinence  at  all  times,  whether  on  or  off  duty. 

On  the  whole  we  may  conclude  that,  for  persons  in  health,  alcohol 
in  any  form  presents  no  advantages  not  found  in  other  foodstuffs  or 
stimulants,  and  which  are,  moreover,  comparatively  free  from  the 
dangers  attending  its  use.     Indeed,  the  subsequent  depressing  effects 


BEPOKTS   OF   THE  PEESIDENt's  HOMES   COMMISSION.  241 

and  the  baneful  influence  of  its  misuse  should  make  us  careful  in  the 
employment  of  alcohol,  even  for  medicinal  purposes,  especially  when 
rest,  proper  food,  and  some  of  the  beverages  and  stimulants  like  coffee, 
tea,  or  beef  tea  may  accomplish  the  same  object. 

CAUSES   OF   INTEMPERANCE. 

The  writer  has  watched  with  satisfaction  the  physical  development 
of  the  population  of  the  United  States,  which  has  more  than  justified 
the  opinion,  long  since  expressed  by  scientists,  that  a  mixture  of  the 
blood  of  different  nations  of  the  same  race  is  better  than  either  of  the 
parent  stock.  Our  typical  American  is  a  very  different  type  from 
his  English,  French,  Irish,  or  German  ancestor.  As  a  result  of  a 
commingling  of  the  blood,  he  has  developed  into  an  individual  of 
strikingly  superior  physical  and  intellectual  qualities,  destined  to  play 
a  very  important  role  in  the  affairs  of  the  world.  And  yet  one  of  the 
dangers  which  appears  to  threaten  us  is  the  growing  evil  of  intem- 
perance, which  is  intimately  connected  with  our  mode  of  life.  In  a 
general  way,  there  is  no  class  of  men  more  ambitious,  more  industri- 
ous, and  more  fond  of  accumulating  wealth  than  our  people.  The 
very  excellence  of  our  progress  and  its  accelerated  speed  have  quick- 
ened the  pulse,  stimulated  the  nerves  and  intellect,  and  fired  the  amjbi- 
tion  of  men  until  they  overleap  the  limits  of  their  natural  powers. 
Under  this  high-pressure  system  the  rich  and  poor  alike  strain  their 
physical  and  mental  energies.  Rest  and  recreation  seem  impossible  to 
many  and  the  temporary  stimulant  derived  from  the  tempting  cup 
offers,  for  the  time  being,  relief  to  our  physical  and  mental  exhaus- 
tion. It  is,  however,  a  dangerous  remedy.  It  is  like  the  whip  ap- 
plied to  the  tired  horse  and  the  result  is  generally  bad. 

Professor  Kraeplin,  one  of  the  foremost  experts  on  insanity  in 
Europe,  in  his  monograph  on  "Alcohol  and  Youth,"  in  discussing  the 
causes  which  lead  up  to  the  drink  habit,  says : 

The  blacksmith  offers  as  an  excuse  exposure  to  heat,  the  liveryman  pleads 
exposure  to  cold,  the  masons  and  bricklayers  plead  outdoor  exposure,  the 
miller  blames  the  dust,  the  sailor  the  fog,  another  his  wife,  and  still  others 
business  reverses. 

From  this  he  concludes  that  the  very  diversity  of  causes  assigned 
show  that  none  of  them  will  stand  the  test  of  scrutiny.  Mr.  Wurm, 
in  a  very  interesting  address  on  the  alcohol  question,  delivered  at 
Essen,  September  20,  1907,  takes  issue  with  Kraeplin  and  proceeds 
to  present  some  of  the  causes  which  operate  in  the  drink  habit  among 
wage-earners.  The  writer  quite  agrees  with  him  that  the  dust- 
producing  occupations  are  at  least  predisposing  factors,  especially 
when  the  employer  makes  no  attempt  to  furnish  pure  water  or  non- 
alcoholic beverages  to  allay  the  thirst  and  when  the  rules  and  regu- 
lations for  the  prevention  and  removal  of  dust  are  totally  ignored. 
In  like  manner  he  makes  a  strong  plea  for  the  operatives  exposed  to 
extremes  of  high  temperature,  the  inhalation  of  injurious  and  offen- 
sive gases,  and  very  properly  insists  that  the  causes  of  abnormal 
thirst  should  primarily  be  prevented  by  efficient  and  copious  venti- 
lation. He  attributes,  and  we  believe  correctly,  the  drink  habit  so 
prevalent  among  painters  to  the  fact  that  they  resort  most  unwisely, 
upon  the  appearance  of  the  first  symptoms  of  lead  colic,  to  alcoholic 
beverages  to  allay  their  suffering,  when,  as  a  matter  of  fact,  the  most 

S.  Doc.  644.  60-2 17 


242  REPOKTS  OF  THE  PRESIDENT'S  HOMES  COMMISSION. 

rational  preventive  measure  would  be  to  abolish  the  use  of  lead  pig- 
ments altogether.  He  describes,  graphically,  the  exposure  of  quarry- 
men,  stonecutters,  masons,  bricklayers,  joiners,  teamsters,  motormen, 
etc.,  to  the  elements,  and  points  out  that  the  men  engaged  in  con- 
struction work  are  rarely  supplied  with  a  shack  and  a  cook  stove 
where  they  can  warm  up  and  take  their  noonday  meal.  In  the 
absence  of  suitable  conveniences  the  workmen  are  compelled  to  fre- 
quent the  saloons,  and  here  highly  seasoned  tidbits  promote  thirst, 
while  the  social  element  is  also  conducive  to  excesses.  All  of  these 
evil  conditions  are  very  much  aggravated  in  this  country  by  the  per- 
nicious system  of  treating.  This  abominable  custom  can  not  be  too 
strongly  condemned,  as  it  is  almost  as  vicious  as  the  seduction  of  a 
young  man  to  take  his  first  drink.  Many  a  young  man  has  fallen  a 
victim  to  the  habit  by  the  encouragement  of  his  older  companions 
to  "  be  a  man  and  take  a  drink." 

Among  the  causes  stated  by  171  of  the  prisoners  in  the  Washing- 
ton workhouse  investigated  by  Dr.  Paul  B.  Johnson,  we  find  the 
following:  Bad  companions,  dusty  employments,  long  hours  of 
work,  especially  at  night,  exposure  to  cold  and  wet,  work  in  hotels 
and  bottling  establishments;  given  toddy,  beer,  etc.,  as  children  4 
years  old  and  upwards ;  death  of  relatives  and  troubles. 

Mr.  Wurm  considers  the  effects  of  mental  and  bodily  fatigue  as  a 
cause  of  intemperance  and  emphasizes  the  peculiar  effects  of  mental 
strain  combined  with  monotonous  machine  work,  in  which,  after  all, 
constant  attention  is  demanded  to  prevent  accidents  and  spoiled 
products.  Mr.  Emmet  L.  Adams,  master  of  the  American  Machin- 
ists, also  believes  that  the  monotony  of  machine  work,  especially 
when  combined,  as  in  the  naval  gun  shops,  with  strict  orders  not  to 
converse  during  the  work,  is  conducive  to  mental  fatigue  and  empti- 
ness, which  the  wage-earner  seeks  to  counteract  by  the  use  of  alco- 
holic beverages.  In  his  opinion  long  hours,  dirty  work,  and  low 
wages  are  fruitful  causes  of  discontent  and  intemperance. 

POVERTY  AND  DRINK. 

Keferring  to  the  effect  of  low  wages  as  a  cause  of  intemperance, 
Mr.  Wurm  quotes  Prof.  Justus  von  Liebig,  who,  in  1860,  declared: 

Alcoholism  is  not  the  cause,  but  the  result  of  distress.  It  is  the  exception 
to  the  rule  for  a  well-nourished  individual  to  become  a  drunliard.  When,  on' 
the  other  hand,  a  man's  earnings  are  insufficient  to  provide  the  quantity  and 
quality  of  food  required  for  the  restoration  of  his  working  capacity,  sheer 
necessity  compels  him  to  have  recourse  to  alcohol. 

It  will  be  remembered  that  Liebig  was  the  first  to  demonstrate  the 
food  value  of  alcohol,  and  this  view  may  have  been  justified  at  a  time 
when  wages  in  Germany  were  extremely  low,  and  the  cost  of  whisky 
so  nominal  as  to  be  classified  as  one  of  the  most  inexpensive  articles 
of  food.  Wurm  also  quotes  Friedrich  Engel,  who  appears  to  have 
been  aware  of  the  fact  that  the  social  conditions,  as  observed  by  him 
in  England  in  1845,  are  not  only  a  cause  of  alcoholism,  but  that  the 
drink  habit  is  also  very  often  the  primary  cause  of  the  low  standards 
of  living. 

Engel  says: 

Seduction  and  every  possible  temptation  combine  to  produce  the  drink  habit. 
Ardent  spirits  at  present  constitute  the  workiugman's  only  source  of  pleasure. 
He  returns  weary  and  exhausted  from  his  work  to  a  damp,  gloomy,  and  unat- 


REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  243 

tractive  home,  devoid  of  all  the  ordinary  comforts  of  life.  He  is  sadly  In  need 
of  good  cheer  and  encouragement;  his  body  weakened  by  improper  food  and 
exposure  to  bad  air  demands  some  form  of  stimulant.  He  wants  to  meet  his 
friends  and  resorts  to  the  saloon  as  the  only  place  to  gratify  his  longings. 
Under  such  circumstances  drunkenness  ceases  to  be  a  vice. 

We  have,  on  the  other  hand,  the  opinion  of  John  Burns,  the  Eng- 
lish statesman,  himself  a  former  wage-earner,  who,  in  his  lecture  on 
"  Labor  and  drink  "  (p.  5),  declares: 

Drinking  is  bad  enough  in  the  prosperous,  well-fed,  and  comfortable  classes, 
who  can  mitigate  its  heavy  drain  upon  their  health,  strength,  and  resources  by 
rest,  change,  and  counter-attractions.  But  on  the  poor  it  is  an  additional  load, 
piled  upon  their  own  backs,  too  often  by  their  own  hands,  and  nearly  always 
at  the  time  they  are  least  able  to  bear  it.  From  their  strength  as  a  class,  from 
their  powers  of  endurance  as  individuals,  and  from  their  capacity  as  craftsmen, 
it  is  a  never-ending  drain. 

On  page  12,  in  speaking  of  "  Poverty  and  drink,"  he  says : 

The  theory,  dogmatically  asserted,  that  poverty  causes  drink  is  rudely  shaken 
by  the  fact  that  the  drink  expenditure  per  middle  and  upper  class  family  who 
have  the  means,  is  two  and  a  half  times  greater  than  that  of  the  working  class 
family,  although  the  effect  is  less  apparent.  But  the  strongest  answer  is  the 
statistical  fact  that  as  wages  rise  general  drunkenness  follows,  insanity  in- 
creases, and  criminal  disorder  due  to  drink  keeps  pace  with  all  three.  The 
converse  generally  holds  good,  for  in  rural  districts,  where  wages  are  low, 
drunkenness  is  lower,  and  insanity  due  to  drink  is  scarcer.  In  support  of  these 
views  and  tables,  the  prison  commissioners'  report  (p.  16,  Judicial  Statistics, 
1899)  :  "A  year  of  great  prosperity,  1899,  was  also  a  year  of  great  drunken- 
ness." Yet  drunkenness  in  1899,  I  am  pleased  to  say,  per  100,000,  was  much 
lower  than  in  previous  periods  of  prosperity,  as  for  instance  in  1884;  the  year 
1875,  our  busiest  year,  was  the  most  drunken  of  any  recorded. 

It  may  be  urged,  in  extenuation  of  these  deplorable  facts,  that  the  determining 
cause  was  the  previously  low  wages;  also  that  it  is  the  sudden  rise  from  rural 
to  urban  wages  that  sweeps  the  appreciated  wage-earner  from  his  simple,  sober 
ways  to  exciting,  heavy-drinking  habits.  If  this  be  accepted,  it  diminishes 
enormously  the  force  of  the  theory  that  poverty  causes  drink.     *     *     * 

Industrial  prosperity  is  always  the  measure  of  wages,  generally  the  standard 
of  drunkenness,  the  gauge  of  insanity,  and  too  often  the  stimulus  of  crime. 
This  is  strikingly  confirmed  by  that  patient,  devoted,  and  capable  investigator 
Mr.  W.  D.  Morrison:  "A  glance  at  the  criminal  returns  for  a  series  of  years 
will  at  once  show  that  crime  is  highest  in  summer  and  autumn — a  time  when 
occupation  of  all  kinds,  and  especially  for  the  poorest  members  of  the  com- 
munity, is  most  easily  obtained — and  lowest  in  winter  and  spring,  when  eco- 
nomic conditions  are  adverse."  All  these  facts,  instead  of  pointing  to  poverty 
as  the  main  cause  of  drunkenness,  point  the  other  way. 

Wurm  stoutly  maintains  that  in  Germany  higher  wages  have 
created  a  greater  demand  for  the  less  harmful  but  more  expensive 
beverages,  like  wine  and  beer,  and  quotes  from  the  "  Volkstimme,"  of 
Frankfort,  that  in  all  trades  where  there  has  been  a  reduction  in  the 
working  hours  alcoholism  has  diminished,  because  the  men  have  an 
opportunity  to  enjoy  nobler  pursuits  than  to  sit  around  in  common 
saloons. 

Justice  De  Lacy,  of  the  juvenile  court  of  Washington,  informed  the 
writer  that  quite  a  large  number  of  deserted  wives,  pleading  for  com- 
pulsory support,  declare  that  when  their  husbands  earned  from  $2.50 
to  $3.50  a  day  they  led  exemplary  lives,  but  now,  when  they  are  earn- 
ing from  $4  to  $5  a  day,  a  number  of  days  are  lost  in  idleness  by  the 
drink  habit. 

The  writer  does  not  pretent  to  offer  an  authoritative  view,  and  pre- 
fers to  adduce  the  evidence  on  both  sides  of  the  question.  He  is 
strongly  inclined  to  the  belief,  amounting  to  a  conviction,  that  the 


244  REPORTS   OF   THE   PRESIDENT'S   HOMES   COMMISSION." 

subject  is  so  broad  and  the  evil  effects  so  far  reaching  as  to  deserve  a 
systematic  and  exhaustive  study  by  a  special  commission. 

Reference  has  been  made  in  a  former  report  to  the  fact  that  mal- 
nutrition, whether  the  result  of  insufficient  or  improperly  prepared 
food,  or  the  consumption  of  cold  ^actuals,  is  a  very  fruitful  cause  of 
intemperance.  In  our  sociological  study  of  1,217  families  it  was 
found  that  760  wage-earners  carried  dinner  pails,  and  205  were  re- 
ported as  being  accustomed  to  consume  alcoholic  beverages  with  their 
meals.  The  number  in  each  case  was  greater  among  the  white  than 
the  colored  wage-earners.  Everyone  at  all  familiar  with  the  subject 
knows  that  badly  cooked  food,  especially  when  consumed  from  the 
"  cold  dinner  pail,"  produces  derangements  of  the  stomach  and  a 
craving  for  alcoholic  stimulants,  which  in  turn  aggravate  the  original 
gastric  disturbance  and  readily  lead  to  the  drink  habit. 

In  addition  to  the  causes  mentioned,  the  unnecessary  number  of 
saloons,  not  infre(juently  connected  with  employment  agencies  or 
located  in  the  vicinity  of  workshops,  wharves,  and  the  homes  of  wage- 
earners,  increase  the  temptation.  Last,  but  not  least,  the  character- 
istic American  bar — drinks  being  consumed  in  rapid  succession,  aided 
by  the  pernicious  system  of  treating — is  a  very  fruitful  cause  of  the 
drink  habit. 

REMEDIAL.   MEASURES. 

The  remedy  is  difficult  to  suggest.  Prohibition  does  not  prohibit, 
and  all  such  attempts  are  repugnant  to  the  masses  and  lead  to  the  sub- 
stitution of  even  greater  evils,  such  as  the  drug  and  other  morbid 
habits.  In  Doctor  Johnson's  investigation  quite  a  number  of  the 
prisoners  admitted  that  when  unable  to  secure  liquor  they  have  re- 
sorted to  alcohol  diluted  with  water,  hot  water  and  sugar,  soda  water, 
sarsaparilla,  etc.  Wood  alcohol  was  stated  to  be  used  in  the  United 
States  Navy,  obtained  from  shellac  varnish  stolen  from  the  paint 
room,  the  shellac  being  precipitated  by  water  and  the  fluid  poured 
off  and  mixed  with  hot  water  and  sugar.  The  following  substitutes 
for  liquor  were  also  alluded  to :  Duffy's  malt  whisky,  Johann  Hoff 's 
malt  extract,  Jamaica  ginger,  Peruna,  S.  S.  S.,  renewed  prescriptions, 
and  forged  prescriptions.  During  my  army  experience  at  posts  situ- 
ated within  the  heart  of  an  Indian  country  and  where  it  was  imprac- 
ticable to  establish  grog  shops,  within  a  reasonable  distance,  whisky 
was  brought  into  the  garrison  through  the  mail  in  various  disguises, 
or  in  express  packages  and  peddled  in  2-ounce  vials  by  the  soldiers 
themselves.  Others  resorted  to  the  purchase  of  essence  of  ginger, 
lemon,  vanilla,  bay  rum,  alcohol,  patent  and  proprietary  remedies 
containing  alcohol  in  various  percentages ;  hence  even  the  most  favor- 
able environment  failed  to  prohibit.  It  was  not  until  the  establish- 
ment of  the  canteen  system  that  better  conditions  were  offered.  It 
was  the  creation  of  the  soliders'  club,  with  the  sale  of  light  wines, 
beers,  and  nonalcoholic  beverages,  which  reduced  drinking  to  a  mini- 
mum and  promoted  not  only  temperance  and  contentment,  but  also 
lessened  immorality  and  crime. 

In  spite  of  the  fact  that  beer  and  wine  drinking,  viewed  in  the 
abstract,  is  unproductive  of  good,  quite  a  number  of  friends  of  tem- 
perance believe  that  saloons  dispensing  light  wines  and  beers  should 
pay  a  very  much  lower  license  tax  than  those  selling  stronger  alcoholic 
beverages.  They  also  deprecate  the  tendency  to  suppress  the  sale  of 
beer  by  the  quart,  because  it  is  found  that  the  men,  instead  of  "  rush- 


REPOKTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  245 

ing  the  growler,"  will  purchase  whisky  by  the  pint  or  quart  with 
infinitely  more  harmful  effects. 

So  long  as  human  nature  is  weak,  and  the  masses  are  not  properly 
educated,  the  substitution  of  a  lesser  evil  is  not  only  justifiable  but 
will,  in  the  future,  as  it  has  in  the  past,  prevent  excesses  which  are 
fatal  to  soul  and  body.  At  present  every  effort  toward  total  absti- 
nence merely  opposes  theory  to  facts  and  sentiment  to  statistics. 

While  it  is  true  that  nearly  one-half  of  the  population  of  the  United 
States  is  now  living  under  prohibition  liquor  laws  and  nine  States 
have  prohibition  outright,  there  is  no  marked  diminution  in  the  con- 
sumption of  alcoholic  beverages.  One  of  the  immediate  effects  has 
been  an  appalling  increase  in  the  number  of  drug  stores  in  "  dry 
States."  The  subject  was  deemed  of  sufficient  importance  by  Mr. 
Harry  B.  Mason,  editor  of  the  "  Bulletin  of  Pharmacy,"  to  bring  it 
to  the  attention  of  the  American  Pharmaceutical  Association  at  a 
meeting  held  at  Hot  Springs,  September  6,  1908. 

Mr.  Mason  said  in  part: 

We  are  facing  a  great  world  movement.  It  has  been  instituted  by  society 
for  the  protection  and  maintenance  of  its  own  interests.  It  will  continue  its 
onward  development  whether  we  like  it  or  not,  and  as  pharmacists  we  are  af- 
fected in  so  vital  a  manner  that  our  future  reputation  and  welfare  are  largely 
at  stake.  Prompt  and  vigorous  measures  are  necessary  if  we  are  to  avoid 
public  calumny  and  disgrace. 

Why?  For  the  very  simple  and  apparent  reason  that  a  small  minority  of 
druggists  are  willing,  nay,  eager,  to  take  advantage  of  the  downfall  of  the  sa- 
loon and  seize  upon  the  business  which  it  is  no  longer  able  to  continue.  In 
some  of  the  prohibition  States,  and  in  most  of  the  "  dry  "  towns  and  counties, 
it  is  recognized  that  liquor  is  a  medicinal  necessity,  and  the  druggist  is  conse- 
quently given  the  legal  right  to  dispense  it  for  legitimate  purposes.  Some- 
times a  physician's  prescription  is  demanded ;  in  other  instances  it  is  provided 
that  the  sale  must  be  only  for  "  medicinal,  chemical,  and  sacramental  purposes," 
and  strict  registration  of  every  sale  is  required ;  in  still  other  sections,  different 
methods  are  prescribed,  but  the  fundamental  expectation  everywhere  is  that 
the  pharmacist  shall  observe  the  spirit  of  the  law  and  refrain  from  selling 
liquor  as  a  beverage. 

Now,  it  is  unquestionably  wise  and  proper  that,  by  some  method  or  other, 
people  who  need  liquor  for  legitimate  purposes  should  be  left  with  the  means 
of  procuring  it,  and  the  drug  store  is  the  natural  and  practically  the  only  place 
to  look  to  in  such  an  emergency. 

No  article  in  the  materia  melica  is  more  useful  and  necessary  than  liquor, 
and  it  would  be  unfortunate,  indeed,  if  pharmacists  were  everywhere  denied  the 
legal  right  of  dispensing  it.  It  would  be  nothing  short  of  a  professional  dis- 
grace of  the  most  humiliating  character  if  this  privilege  were  to  be  taken  from 
us  through  inability  on  our  part  to  respect  it  in  letter  and  spirit,  and  yet  this 
very  thing  has  been  done  in  some  States  and  sections  and  is  threatened  in 
others. 

Every  county  or  city  association  in  "  dry "  territory  might  well  make  the 
matter  a  local  issue,  take  control  of  the  situation,  outline  a  policy,  eject  mem- 
bers who  violate  the  law,  cooperate  with  the  legal  authorities,  and  convince 
the  public,  the  newspapers,  and  the  officers  of  the  law  that  pharmacy  is  a  dig- 
nified and  honorable  occupation  which  will  tolerate  no  liquor  abuses.  This, 
as  I  see  it,  would  prove  the  most  effective  method  of  remedying  the  evil  and 
averting  the  crisis. 

As  a  result  of  Mr.  Mason's  address,  the  association  adopted  resolu- 
tions declaring  that  any  druggist  who  goes  into  the  illegitimate  sale 
of  liquor  is  a  disgrace  to  the  profession  and  should  be  ostracized  by  it, 
and  calling  upon  the  local  authorities  to  assist  in  exposing  and 
penalizing  those  druggists  who  abuse  their  privileges  and  who  thus 
drag  the  name  of  pharmacy  into  the  mire  of  infamy  and  degradation. 

Laudable  as  this  effort  is,  it  will  prove  of  little  avail  until  higher 
moral  standards  reach  all  classes,  including  even  the  liberal  profes- 


246  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSIOK. 


sions.  The  American  Medical  Association  has  preached  for  years 
against  the  nefarious  traffic  in  secret  and  proprietary  medicines,  but 
in  spite  of  solemn  protests  and  ostracism,  the  frightful  list  of  such 
harmful  compounds  increases  at  the  rate  of  about  200  a  year.  Mounte- 
banks and  hypocrites  are  not  easily  subdued  and  when  compelled  to 
respect  the  liquor  law  may  have  recourse  to  a  number  of  medicinal 
preparations  which  are  protected  hj  patents  or  trade-marks.  The 
following  list  of  medicinal  preparations  have  been  analyzed  in  the 
office  of  the  Commissioner  of  Internal  Kevenue  and  are  classed  as 
compound  liquors  for  the  sale  of  which  a  special  tax  is  required : 

Patent  and  proprietary  compounds  containing  sufficient  alcohol  to  he  intoxicants. 


American  Alimentary  Elixir 

Angostura  Aromatic  Tincture  Bitters... 

Aroma  Stomach  Bitters 

Aromatic  Bitters 

Atwood's  La  Grippe  Specific 

Augauer  Kidney  Aid 

Augauer  Bitters 

Belvedere  Stomach  Bitters 

Bismarck  Laxative  Bitters 

Biamarck's  Royal  Nerve  Tonic 

Blackberry  (Karles  Medicine  Company) 
Blackberry  Cordial  (LQtemational  Co.). . . 
Blackberry  Cordial  (Irondequoit  WineCo. ) 
Blackberry  Cordial  (Strother  Drug  Co)  . . . 
Blackberry  &  Ginger  Cordial  (Standard 

Chemical  Co.) 

Black  Tonic 

Bonekamp  Stomach  Bitters 

Bonekamp  Bitters 

Brown's  Aromatic  Cordial  Bitters 

Brown's  Utryme  Tonic 

Brown's  Vin  Nerva  Tonic 

B  otanic  Bitters 

Celery  Pepsin  Bitters 

Cinchona  Bitters 

Clifford's  Cherry  Cure 

Clifford's  Peruvian  Elixir 

Cooper's  Nerve  Tonic 

Crescent  Star  Jamaica  Ginger 

Coca  Wine 

Callsaya 

Cuban  Gingeric 

Dandelion  Bitters 

De  Witt's  stomach  Bitters 

Dr.  Brown's  Blackberry  Cordial 

Dr.  Brown's  Tonic  Bitters 

Dr.  Hopkin's  Union  Stomach  Bitters 

Dr.  Hoffman's  Golden  Bitters 

Dr.  Sterki's  Ohio  Bitters 

Dr.  Dade's  Blackberry  Cordial 

Dr.  Bouvler's  Buchu  Gin 

Dr.  Fowler's  Meat  &  Malt 

Dr.  Gray's  Tonic  Bitters 

Dr.  Hortenbach  Stomach  Bitters 

Dr.  Worme's  Gesundheit  Bitters 

Dr.  Ratthiger's  Bitters 

Dubonnet 

Dubonnet  Wine 

Duffy's  Malt  Whiskey  (Whiskey) 

Ducro's  Alimentary  Elixir 

Elixir  of  Bitter  Wine  (Pleasant  Tonic 

Bitters  Co.) 

Elixir  Calisava 

Eucalyptus  Cordial 

Ferro  China  Bascal 

Ferro  China  Bissler 

Ferro  Quina  Bitters 

Fhie  Old  Bitter  Wine 

Gastrophan 

Gentian  Bitters 

Genuine  Bohemian  Malted  Bitter  Wine 

Tonic 

Gilbert's  Rctjuvenating  Iron  and  Herb 

Jnloe. 


Alcohol 

by 
volume. 


Per  cent. 
16.16 
45.00 
19.60 
42.14 
32.70 
35.65 
34.13 
20.32 
2L14 
20.67 
16.35 
19.84 
19.96 
2L50 

25.62 
44.62 
20.34 
37.03 
42.14 
19.45 
27.32 
20.44 
18.82 
27.44 
35.90 
24.77 
16.55 
42.65 

10.75 
31.09 
30.15 
23.86 
29.04 
19.64 
15.82 
26.30 
2L67 
28.84 
39.83 
33.70 
18.30 
15.89 
27.92 
27.10 

18.74 

23.01 

16.94 
22.96 
9.18 
32.10 
28.87 
16.96 
18.35 
26.10 
39.95 

13.28 

23.81 


Ginger  Tonic 

Ginseng  Cordis 

Glycerine  Tonic  (Elixir  Pepsin) 

Green's  Chill  Tonic 

Greiner's  Blackberry  Cordial 

Harrison's  Quinine  Tonic 

Health  Bitters 

Herbton 

Herbs  Bitters 

Jack  Pot  Laxative  Bitter  Tonic 

Jarvis  Blackberry  Brandy 

Jerome's  Dandelion  Stomach  Bitters. 

Jones'  stomach  Bitters 

Juni-Kola 

Juniper  Kadney  Cure 

Karlsbader  Stomach  Bitters 

Katamo 

K.K.K 

Kola  and  Celery  Bitters 

Kola  Wine 

Kreuzberger's  Stomach  Bitters 

Kudros 

Lee's  Celebrated  Stomach  Bitters 

Lemon  Ginger 

LaxaBark  Tonic 

Magen  Bitters 

MetaMulta 

Mikado  Wine  Tonic 

Milbum's  Kola  &  Celery  Bitters 

Miod  Honey  Wine 

Neuropin 

Newton's  Nutdtive  Elixir 

O'  Hare's  Bitters 

ObermueUer's  Bitters 

Old  Dr.  Jacques  Stomach  Bitters 

Old  Dr.  Scroggin's  Bitters 

Our  Ginger  Brandy 

Ozark  Stomach  Bitters 

Panama  Bitters 

Pepsin  Stomach  Bitters 

Peptonic  Stomach  Bitters. 

Pioneer  Ginger  Bitters 

Quinquina  Dubonnet 

Rimsovo  Malto-Sove  Vino  Chino 

Rockandy  Cough  Cure 

Royal  Pepsin  Tonic 

Scheetz  Bitter  Cordial 

Severa's  Stomach  Bitters 

Sirena  Tonic 

Smart  Weed 

Smith' s  B itters , 

Steinkonig's  Stomach  Bitters 

St.  Raphael  Quinquina 

Strauss  Exhilarator 

Tatra(Latra) 

Tolu  Rock  and  Rye 

True's  Magnetic  Cordial , 

U-Go 

Uncle  Josh's  Dyspepsia  Cure 

Warner's  Stomach  Bitters , 

WestphaUa  Stomach  Bitters 

White's  Dyspepsia  Remedy 

William's  Kidney  Relief 

Zeman's  Medicinal  Bitter  Wine 


REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  247 

The  percentage  of  alcohol  was  ascertained  from  the  Commissioner 
of  Internal  Kevenue  in  a  communication  dated  November  28,  1908.<* 

On  the  whole  the  problem  must  be  solved  by  educational  methods, 
and  hygiene  offers  many  valuable  suggestions.  It  teaches  that  intem- 
perance is  a  vice  the  result  of  a  violation  of  natural  laws,  and  in  order 
to  eradicate  the  evil  and  far-reaching  consequences  we  must  endeavor 
to  remove  the  primary  causes.  Reference  has  been  made  to  mental 
and  physical  fatigue  as  an  important  predisposing  factor.  The  indi- 
cations are  to  regulate  our  life  so  that  we  do  not  burn  the  candle  at 
both  ends,  take  more  rest,  more  recreation,  and  more  interest  in  gen- 
teel amusements  calculated  to  counteract  the  influence  of  saloons. 
The  eight-hour  labor  law  is  indicated  in  the  interest  of  health  and 
morals.  Quite  a  number  of  clear-headed  employers  appreciate  their 
responsibility  in  this  matter  and  have  appointed  social  secretaries, 
"  whose  duty  it  is  to  watch  not  only  over  the  health,  comfort,  and 
happiness  of  the  force  during  working  hours,  but  also  to  obtain 
sufficient  knowledge  of  their  private  life  to  be  a  real  help  in  times  of 
trouble.  The  secretary  establishes  luncheon  rooms,  rest  rooms,  mutual 
aid  associations,  thrift  funds,  and  penny  provident  banks.  Besides 
the  usual  betterment  features  the  secretary  also  arranges  many  forms 
of  amusements,  such  as  dances,  lectures,  and  musicales.  If  this  func- 
tionary did  nothing  more  than  to  teach  working  people  how  to  en- 
joy themselves  in  a  sane,  healthy  way  the  work  would  be  justified. 
*  *  *  The  cardinal  principle  of  the  social  secretary's  gospel  are 
sanitation,  recreation,  and  equalization."  (Review  of  Reviews, 
August,  1906.) 

Hygiene  long  ago  recognized  that  dust-producing  occupations,  ex- 
posure to  extremes  of  heat  and  cold,  and  to  the  inhalation  of  offensive 
gases,  etc.,  are  fruitful  causes  of  disease  in  general  and  the  drink  habit 
in  particular,  and  has  also  pointed  out  how  the  injurous  effects  may 
be  prevented  or  at  least  mitigated.  Until  this  is  accomplished  by 
universal  factory  sanitation,  pure  drinking  water  and  nonalcoholic 
beverages  should  be  furnished  by  the  employer.  Indeed,  efforts  are 
being  made  in  Germany  to  limit  in  every  reasonable  way  the  con- 
sumption of  alcoholic  beverages  by  the  establishment  of  canteens  in 
industrial  plants  for  the  sale  of  coffee,  tea,  cocoa,  milk,  hot  soups, 
and  soft  drinks  of  every  description,  all  of  which  allay  thirst,  while 
many  are  stimulating  without  the  injurious  effects  of  alcohol. 

In  1905  the  breweries  of  Munich  and  other  Bavarian  cities  stopped 
the  issue  of  free  beer  to  employees,  but  allowed  an  extra  compensation 
of  25  cents  a  day  for  beer  money.  The  consumption  has  been  reduced 
from  an  average  of  6  quarts  to  If  quarts  for  each  employee  a  day. 

Money  spent  in  temperance  saloons,  especially  for  warm,  whole- 
some food  and  drinks,  will  be  a  good  health  investment,  provided,  of 
course,  they  are  consumed  within  reasonable  limits.  It  may  be  stated 
in  general  terms  that  while  coffee,  tea,  coca,  spices,  and  condiments 
in  moderation  stimulate  the  central  nervous  system,  and  increase  tem- 

«  Compiled  from  Circular  No.  713,  December  3,  1907,  and  No.  727.  Circular 
No.  713  contains  the  following  paragraph :  "  It  must  be  clearly  understood, 
however,  that  the  list  here  given  is  not  exclusive  and  does  not  purport  to  give 
the  names  of  all  the  preparations  for  the  sale  of  which  special  tax  is  or  may- 
be required,  but  embraces  only  those  which  have  been  analyzed  by  this  oflSce, 
and  held  to  be  insufficiently  medicated  to  render  them  unsuitable  for  use  as  a 
beverage.    *    ♦    ♦>» 


248  REPORTS  OF  THE  PRESIDENT'S  HOMES  COMMISSION. 

porarily  the  elasticity  of  mind  and  body,  their  abuse  is  fraught  with 
danger,  and  we  may  have  "coffee  and  tea  topers"  who  suffer  from 
diseases  of  the  nervous  system. 

One  of  the  most  effective  weapons  against  intemperance  will  be 
found  in  the  thorough  training  of  our  girls  in  domestic  science, 
preferably  in  the  public  schools.  Apart  from  the  fact  that  the  aver- 
age expenditures  for  food  are  larger  than  for  any  other  single  item, 
the  question  of  well  selected  and  properly  cooked  food  and  of  "  home 
making  "  generally  is  of  the  utmost  importance  to  the  health  and 
morals  of  the  community.  No  woman  can  aspire  to  higher  accom- 
plishments than  to  be  a  good  cook ;  and  a  true  "  housewife  "  can  do 
more  for  the  physical  and  moral  development  of  her  family,  and  the 
cause  of  temperance,  than  all  the  moralists  combined.  A  thoughtful 
mother,  apart  from  seeing  that  her  family  is  supplied  with  good 
food,  will  also  make  the  home  attractive,  inculcate  aesthetic  home 
tastes,  and,  above  all,  a  spirit  of  thrift  and  economy.  The  habit  of 
saving  money  can  not  be  too  strongly  urged  upon  children,  and 
when  once  strongly  rooted  offers  one  of  the  best  safeguards  against 
expenditures  for  immoral  purposes.  The  beneficent  effects  of  the 
provident  savings  system  are  fully  recognized  by  charity  workers 
and  quite  a  number  of  American  cities  have  introduced  the  stamp- 
saving  system  into  the  public  schools. 

Much  may  be  done  for  the  cause  of  temperance  and  general  sani- 
tation by  introducing  the  subject  of  hygiene  as  a  part  of  the  curricu- 
lum in  our  schools  and  colleges,  so  that  the  children,  the  future 
parents  and  citizens,  may  acquire  accurate  knowledge  upon  this  and 
other  subjects  in  relation  to  health  and  disease. 

Apart  from  educational  methods  we  should  bear  in  mind  that  man 
is  essentially  a  social  animal  and  if  he  asks  for  bread  we  have  no 
right  to  offer  him  a  stone.  He  needs  opportunities  for  recreation  to 
vary  the  monotony  and  turmoil  of  life,  and  many  a  young  man,  with 
the  best  of  intentions,  has  found  his  way  to  saloons  and  places  of 
evil  resort  for  lack  of  better  opportunities.  When  we  supply  clean  and 
decent  amusements  we  can  indeed  hope  for  a  higher  cultivation  and 
moral  training  of  the  male  youth  of  all  classes.  The  writer  notes 
with  gratification  that  such  an  effort  was  made  in  1902  by  the  estab- 
lishment of  the  "  Everett  Clark  Club  House,"  the  gift  of  Mrs.  Potter, 
wife  of  the  Bishop  of  New  York,  and  her  son.  Lieutenant  Clark, 
U.  S.  Army,  to  the  members  of  Grace  Episcopal  Church,  Elizabeth, 
N.  J.  The  special  interest  of  this  gift  lies  in  the  fact  "  that  it  is  a 
signal  example  of  intelligent  contribution  to  the  needs  of  the  whole 
man — religious,  physical,  social,  and  aesthetic.  Under  one  roof  there 
is  a  chapel,  kitchen,  restaurant,  dining,  reading,  card,  committee, 
smoking,  shuffle  board,  and  billiard  room,  a  swimming  tank  and  other 
baths,  gymnasium,  running  track,  and  bowling  alleys."    (Outlook.) 

Similar  efforts  have  been  made  in  connection  with  our  local 
churches,  and  it  is  to  be  hoped  that  the  time  is  not  far  distant  when 
every  church  and  school  in  the  land  will  also  become  a  social  center. 

The  writer  is  familiar  with  the  excellent  results  obtained  in  one  of 
the  Boston  churches,  in  cooperation  with  the  medical  profession,  in 
the  cure  of  consumptive  and  nervous  invalids.  While  not  deprecat- 
ing such  efforts,  it  must  be  conceded  that  the  most  substantial  and 
permanent  results  will  be  achieved  by  preventive  rather  than  curative 


EEPORTS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  249 

measures,  which  primarily  involves  the  removal  of  the  cause.  So, 
for  example,  every  effort  to  diminish  intemperance,  the  drug  habit, 
and  sexual  excesses  will  reduce  the  number  of  nervous,  mental,  and 
moral  wrecks.  Likewise  every  effort  to  improve  the  housing  condi- 
tions and  standards  of  living  will  diminish  the  number  of  con- 
sumptives. 

It  is  sincereljr  hoped  that  the  wage-earners  of  this  country,  in  addi- 
tion to  cultivating  home  life  and  higher  ideals,  will  hold  their  meet- 
ings in  buildings  wholly  divorced  from  saloons,  along  strictly  ethical 
lines,  and  in  every  way  in  keeping  with  the  dignity  of  labor.  There 
is  certainly  room  for  special  buildings  dedicated  to  the  improvement 
of  artisans  and  their  industrial  and  social  conditions. 

RECREATION    AND   INEXPENSIVE   AMUSEMENTS. 
[By  Mabel  T.  Boardman.] 

That  all  people,  from  the  lowest  savages  to  the  most  civilized 
races,  crave  recreation  and  amusement  is  a  fact  that  is  recognized  by 
all,  but  the  importance  of  providing  sane  and  wholesome  entertain- 
ment to  satisfy  this  craving  is  too  much  overlooked  in  the  case  of  the 
least  resourceful  people.  The  playground  system,  boys'  and  girls' 
clubs,  and  social  settlement  entertainments  are  fortunate  movements 
along  this  line  as  far  as  children  are  concerned,  but  too  little  has  been 
done  to  meet  this  same  desire  in  the  older  generation.  The  habits 
of  intemperance  and  kindred  vices  are  formed  not  in  a  man's  working 
but  in  his  recreation  hours.  The  saloon  has  been  frequently  called 
"  The  poor  man's  club,"  and  it  is  quite  natural  that  a  man's  social 
inclination  should  take  him  where  he  may  find  congenial  company. 
He  desires  the  recreation  of  a  chat  with  his  fellow-men.  His  home 
is  too  small,  or  too  much  occupied  by  his  family,  for  him  to  gather 
with  them  there.  The  factories,  or  the  other  places  where  he  may 
work,  are  closed,  and  where  save  in  the  saloon  can  he  find  the  com- 
panionship he  desires  ?  He  can  not  frequent  a  saloon  without  becom- 
ing its  patron,  and  while  at  first  he  seeks  it  merely  for  the  sake  of 
social  companionship,  he  may  become  its  habitue  for  the  sake  of 
drink. 

It  is  unfortunate  that  in  this  country  there  exist  so  few  places  like 
the  beer  gardens  and  halls  of  Germany,  where  a  man  can  take  his 
family  and  at  a  very  small  expense  listen  to  good  music,  gossip  with 
his  friends,  and  spend  a  sane  and  wholesome  evening.  If  only  the 
philanthropists  of  a  city  would  build  and  partially  endow  some  large 
amusement  hall,  so  constructed  that  in  summer  it  could  be  turned  into 
an  almost  ©pen-air  garden,  where  every  evening  a  good  orchestra 
would  provide  popular  music,  or  some  unobjectionable  vaudeville 
performance  be  given,  while  the  men  could  sit  talking  and  smoking 
around  the  tables,  their  families  gathered  about  them,  a  great  deal 
could  be  accomplished  in  the  way  of  keeping  them  from  the  tempta- 
tions the  saloon  affords.  Young  men  and  women  of  the  families 
could  have  a  respectable  place  in  which  to  meet,  and,  with  some  over- 
sight, arrangements  might  be  made  for  part  of  the  large  hall  to  be 
devoted  to  dancing.    Soft  drinks  and  beer  could  be  sold.    Men  and 


250  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION". 

women  whose  daily  labor  may  be  of  a  nature  that  requires  little 
mental  work  would  find  the  daily  task  much  lightened,  for  while 
their  hands  are  occupied  with  routine  work  their  minds  would  be 
filled  with  the  memories  of  a  pleasant  yestereven  or  the  anticipation 
of  another  one  to  come. 

The  dreary  and  monotonous  home  lives  of.^many  of  the  women 
would  not  only  be  lightened  by  the  opening  of  such  great  halls  during 
the  afternoon  hours,  but  the  opportunity  on  cold  and  rainy  days  in 
winter,  or  on  the  hot  days  in  summer,  of  keeping  their  children  about 
them  in  a  physically  and  morally  healthful  atmosphere  would  prove 
of  great  benefit.  The  influence  of  the  mother  over  her  children  is  far 
greater  than  can  be  that  of  the  father,  whose  work  keeps  him  so  much 
occupied  during  the  day,  and  anything  that  can  help  to  improve  and 
better  her  existence  can  not  fail  to  directly  affect  that  of  her  children. 
For  a  time  taken  out  of  the  drudgery  of  her  daily  life  amused  and 
entertained,  much  of  the  dull  and  tired  feeling  that  often  makes  her 
cross,  nagging,  and  irritable  will  depart,  and  the  home  will  become 
a  far  happier  place  for  the  husband  and  children. 

Educational  departments  have  in  many  cities  wisely  provided  pub- 
lic lectures  on  a  great  variety  of  subjects,  mainly  of  an  educational 
character,  but  human  nature  does  not  wish  to  devote  all  its  hours  of 
recreation  to  improving  its  mental  conditions.  It  desires  relaxation ; 
it  wants  to  be  amused.  The  children  of  the  larger  growth  need  their 
play  time,  too,  and  it  is  to  the  satisfying  of  this  craving  on  the  part 
of  the  least  resourceful  people  that  too  little  consideration  has  been 
given.  Of  themselves  they  can  provide  little  or  nothing,  and  the 
natural  desire  for  amusement  makes  them  too  often  the  prey  of  the 
saloon,  the  cheap  sensational  theater,  or  the  morbid  shows  of  the 
penny-in-the-slot  character.  Thousands  of  boys  and  girls  leave  school 
every  year  at  the  most  formative  period  of  their  lives,  and  the  nature 
of  the  recreations  and  amusements  they  indulge  in  will  have  a  lasting 
influence  and  may  properly  be  considered  as  having  still  to  do  with 
their  education  in  a  broad  sense.  The  enormous  growth  of  the  5 
and  10  cent  theaters  and  their  popularity  in  all  of  our  large  cities  is 
sufficient  proof  of  the  need  of  cheap  amusements.  When  the  enter- 
tainments provided  by  them  are  sane  and  wholesome,  even  though 
not  of  the  most  elevated  nature,  they  should  be  encouraged,  but  cer- 
tain powers  of  supervision  over  these  places  should  lie  m  the  hands 
of  some  civic  authority,  possibly  the  board  of  education. 

Public  lectures  of  a  popular  nature,  travel  monologues  with  ster- 
eopticon  views,  etc.,  should  be  provided  by  the  educational  depart- 
ment of  the  city  and  the  public  schools  used  for  this  purpose  in  the 
evenings.  Doubtless  volunteers  for  many  such  lectures  could  be 
secured,  so  that  with  lecturers  and  places  provided  free  of  cost,  the 
expense  need  not  be  great.  The  parish  halls,  chapels,  and  Sunday 
school  buildings  of  churches  might  also  be  utilized  for  this  purpose. 

If  the  importance  of  healthful  and  wholesome  amusement  to  gratify 
this  demand  of  human  nature  is  recognized  and  provided  for,  there 
is  no  doubt  there  would  result  a  marked  reduction  of  intemperance 
among  the  least  resourceful  people  and  a  general  uplift  in  their 
social  condition. 


EEPOBTS   OP  THE  PRESIDEKT  S  HOMES  COMMISSION. 


251 


Chapter  X. 


THE   DRUG   HABIT. 


The  writer,  as  a  member  of  a  committee  of  the  Medical  and  Surgical 
Society  of  the  District  of  Columbia,  appointed  in  1896  to  investigate 
the  extent  of  the  opium  habit,  had  occasion  to  witness  the  physical 
and  moral  impoverishment  which  results  from  the  use  of  drugs  which 
enslave. 

The  report  of  the  committee  was  published  as  Senate  Document 
No.  74,  Fifty-fourth  Congress,  second  session,  and  shows  that  during 
the  ten  years  ending  June  30,  1895,  7  persons  died  from  the  opium 
habit,  36  persons  died  from  accidental  or  negligent  opium  poisoning, 
and  36  committed  suicide  with  opium  or  its  preparations.  Of  the 
accidental  deaths  12  were  under  5  years  of  age,  while  the  remainder 
were  over  20  years  of  age. 

The  statistics  have  been  extended  by  Dr.  H.  C.  Macatee,  and  are 
as  follows: 


1 

B 

a 

1 

Suicides  from  poison- 
ing by- 

Accidoi 
fatal 

tal  or  negligent 
poisoning  by — 

Year. 

Nar- 
cotic 
poisons. 

Corro- 
sive 
poisons. 

Miscel- 
laneous, 
includ- 
ing car- 
bolic 
acid 
and  gas. 

Nar- 
cotic 
poisons. 

Corro- 
sive 
poisons. 

Miscel- 
laneous, 
includ- 
ing car- 
bolic 
acid 
and  gas. 

Deaths 
from 

alcohol- 
ism. 

5^' 

H. 

o 

i 

i 

.0 

lO 

I2 

0 

lO 

6  "■ 

0  ,0 

1886                   .                         

1 

2 
1 

1 

1887 

2 

.... 

1888 

1889 

2 
1 
2 

1 
5 
3 
6 
4 
5 
9 
7 
4 
4 
2 
3 
9 

1 
1 
1 
3 
5 
9 
3 
4 
4 
5 
6 
4 
9 

s 

1 

d3 
4 

1890 

1891 

2 

1892 

'  * 

1893 

3 
2 
3 

1 

"2 
1 

di 

1894 

1895 

1 

.... 

1896 

3 
9 

7 

6 
1 

1 
1 
3 
3 

.... 

.... 

2 

10 

2 

1 

6 

10 

12 

4 

14 

20 

19 

20 

/SI 

""3' 
1 
1 

""i" 

1 
2 

8 

1 

1897  ...            

12 

a3 

1 

3 

blO 

:::. 

1898 

1899 

2 

1 
2 

"2 

.... 

17 

1900 

21 

1901 

2 

1 

34 

1902 

15 

1902  (July  1  to  Dec.  31 ) 

1 

d6 
d7 
d4 
1 
d3 

1 
18 
all 
9 
3 
5 

:::: 

9 

1903.. 

3 

23 

22 

1904 

6 
4 
1 
3 

1905 

1 

24 

1906 

1 
2 

....    e-S 

03 

1907 

2 

im 

32 

Total 

15 

87 

.... 

40 

151 

23     70 

9 

8 

24 

76 

..... 

287 

That  part  of  the  table  for  the  years  ending  June  30,  1886  to  1805,  inclusive, 
piled  by  Doctor  Kober,  and  refers  to  opium  only. 

"  One  from  cocaine. 

''  One  from  paraldehyde. 

''One  from  quick  pain  killer  (opium). 

"  Eleven  from  opium. 

«  One  froffn  chloralhydrate. 

f  Nineteen  from  gas. 


252  REPORTS   OF   THE   PRESIDENT'S   HOMES   COMMISSION. 

In  addition  there  were  treated  during  the  same  period  in  the  four 
hospitals  of  this  city  125  cases  of  opium  poisoning  and  70  patients 
for  the  opium  habit.  Doctor  Macatee  has  continued  this  investigation 
up  to  date  and  finds  that  during  the  last  nine  years  256  patients  have 
been  treated  for  the  opium  habit  in  seven  of  our  hospitals,  and  62 
patients  for  the  cocaine  habit  in  three  of  our  hospitals.  The  report 
of  the  committee  referred  to  says: 

Witliout  a  most  exhaustive  collective  investigation  it  is  impossible  to  even 
estimate  the  number  of  persons  treated  by  physicians  for  acute  or  chronic 
opium  poisoning  who  may  recover  from  the  immediate  effects  of  the  drug,  or 
who  have  died  victims  of  the  opium  habit  and  in  which  the  cause  of  death 
may  have  been  assigned  to  some  remote  pathological  effects  of  the  drug. 

The  investigation  of  the  committee  revealed,  however,  the  fact 
that  "  there  are  quite  a  large  number  of  persons  in  this  city  who  have 
become  the  victims  of  the  opium  habit,  and  that  the  different  prepa- 
rations of  the  drug  are  used  in  the  following  manner: 

1.  The  hypodermic  injection  of  morphia. 

2.  The  use  of  morphia  by  the  mouth  and  rectum. 

3.  The  use  of  alcoholic  preparations  of  opium  by  the  mouth. 

4.  The  use  of  gum  opium  by  the  mouth  (opium  eating). 

5.  The  use  of  the  extract  of  opium  by  inhalation  (opium  smoking). 
In  regard  to  the  actual  extent  of  the  morphine  habit  and  the 

amount  consumed,  either  by  the  hypodermic  method,  by  the  mouth 
or  rectum,  it  is  difficult  to  present  any  definite  data,  but,  judging 
from  the  statements  of  our  pharmacists,  there  is  scarcely  one  who 
does  not  recall  one  or  more  victims  to  the  drug,  and,  while  many 
refuse  to  sell  morphia  in  unusual  quantities,  it  is  evident  from  their 
sales,  general  observations,  and  calls  for  the  drug,  that  the  habit  is 
widespread ;  some  of  the  victims  use  as  high  as  1  dram  of  morphia 
a  day,  one  store  alone  selling  about  $100  worth  of  morphia  a  month. 

Quite  a  large  number  of  pharmacists  report  sales  in  unusual  quan- 
tities of  the  alcoholic  preparations  of  opium,  such  as  McMunn's 
Elixir,  laudanum,  papine,  Squibb's  Mixture,  and  proprietary  or 
secret  medicines  containing  opium,  the  demand  for  McMunn's  Elixir 
being  especially  active,  while  paregoric  and  Squibb's  Mixture  supply 
the  wants  of  many  victims  to  the  use  of  narcotics. 

The  use  of  gum  opium  (opium  eating  or  chewing)  is  not  so  very 
common.  Nevertheless,  a  sufficient  number  of  sales  in  suspicious 
quantities  reveals  the  existence  of  habitues  to  this  form  of  the  drug. 
In  regard  to  the  use  of  the  extract  of  opium  by  inhalation  (opium 
smoking)  the  data  are  quite  meager.  Pharmacists  have  occasional 
calls  for  the  extract,  but  are  of  the  opinion  that  the  bulk  is  supplied 
by  Chinese  merchants.  Dr.  Wade  H.  Atkinson  recently  reported  to 
this  society  a  fatal  case  from  opium  smoking  in  the  person  of  a  white 
man  aged  28.    Doctor  Atkinson,  in  presenting  the  case,  says : 

I  know  of  about  20  in  this  city,  and  I  have  asked  a  few  others  who  could  most 
probably  estimate  the  number  correctly.  A  popular  drug  clerk  estimates  the 
smokers  at  150.  A  very  noted  clerk  in  a  lunch  room  who  is  well  acquainted 
with  several  smokers  consulted  with  them  and  estimated  the  number  at  500. 
A  special  detective  in  the  police  department  says  he  thinks  there  are  not  more 
than  20  smokers,  and  only  one  "joint"  here.  Chinese  are  not  considered  in 
these  estimates.  I  believe  a  fair  average  of  150  or  200  habitual  smokers  are 
in  Washington,  and  know  of  two  "joints." 

Investigation  into  the  causes  of  the  opium  habit  leads  to  the  con- 
clusion that  one  class  of  subjects  have  contracted  the  habit  by  the 


REPORTS   OF    THE  PRESIDENT'S   HOMES   COMMISSION.  253 

dse  of  the  milder  preparations  of  opium,  such  as  McMunn's  Elixir, 
paregoric,  Squibb's  Mixture,  and  some  of  the  various  proprietary  or 
secret  remedies  usually  employed  as  domestic  remedies. 

Another  class  have  evidently  acquired  the  habit  by  the  constant 
use  of  prescriptions  containing  opium  or  its  preparations  for  the 
relief  of  pain,  the  individuals  being  at  first  quite  unconscious  of  the 
enslaving  nature  of  the  drug.  Competent  and  experienced  phar- 
macists are  of  the  opinion  that  prescriptions  containing  opiates  are 
more  frequently  refilled  than  other  prescriptions;  that  copies  of  such 
prescriptions  are  frequently  multiplied  for  friends,  and  that  sup- 
positories containing  opiates  are  commonly  renewed. 

The  social  condition  of  the  foregoing  classes  appears  to  be  of  a 
mixed  character,  and  includes  all  grades  of  society,  the  rich  and 
intellectual  predominating.  Another  class  of  persons  belong  to  the 
moral  degenerates,  or  fast  men  and  women,  who  have  acquired  the 
habit  by  contact  with  opium  habitues  and  through  solicitation,  invita- 
tion, and  persuasion  of  fallen  victims  to  the  vice.  In  the  opinion 
of  many  prominent  pharmacists  the  habit,  from  whatever  cause,  is 
readily  established,  because  opium  and  its  preparations  are  altogether 
too  easily  obtained.  Before  considering  the  question  as  to  the  extent 
to  which  the  State  should  exercise  control  in  the  interest  of  public 
health  over  the  sale  of  poisons  reference  should  be  made  to  the  obli- 
gations of  the  physicians  in  the  matter. 

There  can  be  no  successful  concealment  of  the  fact  that  the  pro- 
longed and  indiscriminate  use  of  opium  and  its  preparations,  espe- 
cially in  neurotic  subjects,  has  been  a  most  fruitful  cause  of  morphin- 
ism, and  while  inquiry  reveals  a  decrease  in  the  amount  of  morphia 
prescribed  by  the  physicians,  there  are  still  a  goodly  number  of 
so-called  "  morphine  doctors  "  who  have  received  this  appellation  by 
pharmacists  because  they  are  in  the  habit  of  making  it  one  of  the 
ingredients  in  nearly  all  of  their  prescriptions. 

In  view  of  the  fact  that  prescriptions  containing  opiates  are  fre- 
quently refilled  and  taken  in  increased  and  unauthorized  quantities, 
and  may  thus  establish  a  habit,  in  the  absence  of  legal  restrictions  all 
physicians  should  endeavor  to  reduce  the  danger  from  morphinism 
to  a  minimum  by  a  judicious  employment  of  the  drug  and  careful 
supervision  of  the  patient. 

While  some  pharmacists  believe  that  the  request  of  the  physician 
on  the  prescription  "  not  to  be  renewed  "  would  be  generally  respected, 
others  believe  that  the  prescription,  having  been  declared  the  personal 
property  of  the  patients,  is  subject  to  their  orders  only.  It  would 
possibly  be  wise  not  to  incorporate  opium  and  its  preparations  in  any 
prescription,  and  when  its  use  is  indicated  it  might  be  dispensed  by 
the  physician  without  the  knowledge  of  the  patient  as  to  the  nature 
of  the  remedy.  But  perhaps  the  easiest  way  to  solve  the  question 
would  be  to  follow  the  lead  of  the  New  York  legislature,  which,  in 
June,  1887,  enacted  a  law  that  no  pharmacist,  druggist,  apothecary, 
or  other  person  shall  refill  more  than  once  prescriptions  containing 
opium  or  morphine,  or  preparations  of  either,  in  which  the  dose  of 
opium  shall  exceed  one- fourth  grain  or  morphine  one-twentieth  grain, 
except  with  the  verbal  or  written  order  of  a  physician. 

The  committee  submitted  drafts  of  two  bills  for  consideration 
which  it  was  believed  would  go  far  toward  preventing  the  spread  of 


254  REPORTS  OF   THE  PRESIDENT'S   HOMES  COMMISSION. 

the  opium  habit,  and  also  expressed  the  opinion  that  with  regard  to 
the  sale  of  proprietary  and  secret  medicines  containing  poisonous 
drugs  the  contents  should  be  clearly  expressed  on  the  label,  and  the 
word  "  poison  "  added,  as  required  in  the  sale  of  poisons  under  ex- 
isting acts.  No  action  was  taken  for  several  years  upon  these  recom- 
mendations, which  were  clearly  in  the  interest  of  public  health  and 
morals.  In  the  meantime  the  cocaine  habit  also  assumed  alarming 
proportions,  so  that  Major  Sylvester,  chief  of  the  police,  in  his  an- 
nual report  for  1904  (p.  27)  called  attention  to  the  fact  that  ex- 
amination of  the  poison  register  of  one  dealer's  place  alone  disclosed 
40  sales  in  one  day.  The  goods  having  been  put  in  properly  labeled 
envelopes,  there  was  no  violation  of  the  law.  In  his  report  for  1905 
(p.  36)  he  pointed  out  that  parties  have  been  apprehended  for 
peddling  the  drug  from  door  to  door,  and  that  some  worthy  and 
capable  people  have  wrecked  their  own  lives  and  made  that  of  others 
miserable.  In  each  of  his  reports  he  urged  appropriate  legislative 
action. 

A  new  pharmacy  law  was  finally  enacted  and  approved  May  7, 
1906,  which  placed  greater  restrictions  upon  the  sale  of  poisons  in 
general  and  the  habit-forming  drugs,  such  as  opium,  morphine, 
cocaine,  chloral  in  particular,  and  also  made  the  filling  of  pre- 
scriptions containing  such  drugs  in  certain  doses,  except  upon  the 
written  order  of  the  signer  of  the  original  prescription,  unlawful. 

The  chief  of  police,  in  his  report  for  1906,  on  page  23,  says : 

The  cocaine  habit  and  sale  is  the  most  diflScult  to  cope  with,  and  the  law 
should  be  so  complete  as  to  prohibit  other  than  licensed  druggists,  physicians, 
dentists,  or  veterinarians  having  it  in  his  or  her  possession  except  on  a 
physician's  prescription,  and  then  the  package  to  bear  the  name  of  the  physi- 
cian and  the  patient  for  whom  prescribed. 

In  the  report  for  1907  he  states  "  that  the  sale  of  cocaine  has  been 
largely  reduced,  but  there  are  many  who  dispense  the  dtug  under 
cover." 

Dr.  Paul  B.  Johnson,  in  his  investigation  of  175  prisoners  in  the 
Washington  workhouse,  found  that  15  had  intimate  knowledge  of 
the  use  of  cocaine.  "  Cocaine  was  described  always  as  used  by 
sniffing  the  powder  into  the  nostrils,  either  from  the  package,  or  from 
the  palm  of  the  hand,  or  from  the  fingers  like  snuff,  or  most  often  by 
dipping  a  short  quill  into  the  powder  and  placing  the  other  end  to 
the  nostril.  It  was  stated  as  easily  purchased  in  drug  stores  or  in 
the  rear  of  barrooms."  Dr.  Lyman  F.  Kebler,  Chief  of  the  Division 
of  Drugs  of  the  Bureau  of  Chemistry,  United  States  Department  of 
Agriculture,  in  a  recent  paper  on  the  "  dope  question,"  refers 
to  the  cocaine  habitue  as  socially  inclined,  offering  a  friend  a 
"sniff."  *  *  *  In  fact,  whole  circles  assemble  to  enjoy  a  cocaine 
spree,  where  the  dope,  commonly  known  as  "  coke,"  is  passed  from 
one  to  another  to  take  an  allotted  sniff.  In  speaking  of  the  effects, 
Doctor  Kebler  states  that  "cocaine  in  some  cases  transforms  other- 
wise safe  and  tractable  citizens  into  dangerous  characters,  and  in 
most  instances  wrecks  the  individual  and  all  depending  on  him,  as 
well  as  jeopardizes  the  lives  of  many." 

Major  Sylvester,  in  a  letter  dated  December  6,  1908,  writes  as 
follows : 

Investigation  shows  that  there  were  about  a  half  dozen  druggists  making  a 
specialtv  of  the  sale  of  cocaine  and  other  drugs,  and  a  dozen  or  more  selling 


BEPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  255 

such  to  a  few  customers;  the  other  druggists  in  the  District  would  not  make 
such  sales  except  to  persons  whom  they  had  reason  to  believe  would  use  the 
same  for  legitimate  purposes,  and  some  of  them  would  not  handle  it  at  all. 

Upon  the  passage  of  the  present  pharmacy  law,  such  sales  were  stopped  by 
druggists,  except  a  limited  number  who  continue  the  sale  to  customers  upon 
whom  they  could  rely  not  to  betray  them,  and  who  were  actuated  by  sympathy 
rather  than  other  motives;  three  or  four  others  continued  the  sale,  only  to  be 
apprehended  and  fined. 

The  member  of  the  force  detailed  as  inspector  of  pharmacy  has  had  occasion 
to  bring  to  court  three  physicians  for  writing  prescriptions  for  morphine  and 
cocaine,  all  of  which  were  aggravated  cases,  and  he  has  given  notice  to  others 
not  to  indulge  in  the  practice. 

The  department,  in  this  work,  has  had  the  cordial  cooperation  of  physicians 
generally,  and  finds  that  in  their  opinion  the  drug  habit,  especially  morphine, 
is  due  largely  to  the  injudicious  prescribing  of  drugs,  and  it  has  evidenced  an 
inclination  on  the  part  of  physicians  to  curtail  the  use  of  them. 

In  the  course  of  his  investigation  the  inspector  found  that  morphine  fiends, 
with  two  exceptions,  had  become  addicted  to  the  use  of  the  drug  through  sick- 
ness or  injury;  one  of  those  excepted  stated  he  formed  the  habit  through  no 
other  cause  than  that  of  the  lowest  depravity,  while  the  other  stated  he  became 
addicted  to  its  use  through  having  it  prescribed  by  a  physician  after  getting 
over  a  long  spree. 

I  am  informed  that  there  are  one  or  two  physicians  who  have  a  few  patients 
whom  they  feel  in  duty  bound  to  supply  with  the  drug. 

It  is  believed  that  if  the  law  could  be  made  stringent  enough  to  put  the  sale 
of  morphine  beyond  the  reach  of  such  persons,  after  they  had  been  treated 
under  confinement,  they  would  make  useful  citizens. 

The  morphine,  laudanum,  and  kindred  drug  users,  according  to  the  observation 
of  the  inspector  of  this  department,  have  been  greatly  reduced  in  number 
through  the  efforts  of  the  medical  profession. 

The  habit  of  opium  smoking  has  never  become  serious  in  this  city;  it  was 
slightly  increased  with  the  passage  of  the  pharmacy  law,  as  the  drug  is  easier 
to  get  from  Chinamen,  who  are  hard  to  detect.  It  is  confined  principally  to 
degraded  persons,  both  white  and  black,  who  are  beyond  reformation.  Arrests 
are  made  by  the  police  and  penalties  imposed  upon  the  Chinese  engaged  in  the 
traffic.  I  think  if  the  penalties  inflicted  were  a  little  more  severe  the  effect 
would  be  more  ample. 

The  inspector  states  that  in  the  course  of  his  investigation  he  has  learned 
of  no  foreign  white  people  who  are  addicted  to  the  drug  habit.  He  finds  that 
the  cocaine  habit  is  by  far  the  greatest  menace  to  society,  because  the  victims 
are  generally  vicious.  The  use  of  this  drug  superinduces  jealousy  and  pre- 
disposes to  commit  criminal  acts.  In  districts  where  druggists  formerly  dis- 
pensed cocaine  disorder  has  decreased  so  noticeably  that  it  is  commented  upon 
by  the  neighbors  and  the  police  officers  on  the  beats ;  it  has  also  had  the  effect 
that  a  large  percentage  of  persons  using  cocaine  will  not  make  an  effort  to  get 
it  when  it  is  accompanied  by  the  risk  of  arrest. 

The  present  source  of  supply  is  mainly  through  druggists  who  are  not  now 
in  the  business,  and  clerks  who  are  employed  at  drug  stores,  who,  it  is  believed, 
deliver  it  to  persons  to  peddle  when  they  can  find  anyone  who  will  purchase. 
Others  procure  it  from  the  near-by  suburban  towns,  localities  without  this 
jurisdiction. 

It  is  quite  a  difficult  matter  to  convict  these  people,  as  possession  of  the  drug 
is  not  held  to  be  sufficient  evidence.  In  Virginia  possession  is  held  to  be  evi- 
dence of  intent  to  sell,  and  is  punishable  by  not  less  than  one  nor  more  than 
five  years  in  jail.  Under  the  present  law  there  is  no  distinction  between  a  clerk 
and  a  proprietor ;  if  a  person  is  registered  he  can  purchase  any  amount.  No 
person  other  than  a  druggist  should  have  the  privilege  of  handling  cocaine. 

It  is  believed  that  there  are  about  a  dozen  persons  who  peddle  cocaine  from 
time  to  time,  and  those  who  use  it  are  numbered  approximately  by  the  in- 
spector's report  at  about  100.  The  number  of  persons  who  use  morphine  can 
not  be  approximated,  as  they  are  distributed  throughout  all  classes  of  society. 
Many  who  use  the  drug  are  not  known  as  such  habitues  outside  of  their  own 
homes.  There  have  been  a  number  of  peddlers  or  writers  of  bogus  prescrip- 
tions arrested  and  fined  from  $50  to  $200,  or  sent  to  jail.  My  information  is 
that  the  sale  of  cocaine  is  about  one-tenth  of  what  it  was  before  the  present 
law  went  into  effect.  ♦  *  * 


256  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

MEDICINAL   PREPARATIONS   WHICH   CONTAIN    HABIT-FORMING   DRUGS. 

Doctor  Kebler  says: 

There  are  upon  the  market  many  medical  preparations  which  contain  as 
ingredients  habit-forming  drugs.  Such  drugs  are  alcohol,  opium  and  its  deriva- 
tives, notably  morphine,  codeine,  and  heroin;  cocaine,  chloral,  Cannahis  indica, 
acetanilid,  etc. 

The  presence  of  most  of  the  habit-forming  drugs,  under  the  pro- 
visions of  the  pure  food  and  drugs  act,  must  now  be  declared  upon 
the  label  of  drug  products,  and  the  public  is  thus  made  aware  to 
some  extent  of  the  nature  of  preparations  containing  these  agents. 
The  drug  products  which  contain  opium  and  it  derivatives  most  fre- 
quently are  the  painkillers,  cough  and  consumption  cures,  and  sooth- 
ing sirups. 

Below  is  given  a  list  of  some  of  the  medicinal  preparations  which 
contain  habit-forming  drugs  other  than  alcohol: 

Coco-Bola  (cocaine).  Dr.      Seth     Arnold's     Cough     Killer 

Godfrey's  Cordial  (opium).  (morphine). 

Harrison's  Opium  Elixir  (opium).  Piso's  Cure  (CannaMs  indica). 

Wright's  Instant  Relief  (opium).  Boschee's  German  Syrup   (morphine). 

Grossman's  Specific  Mixture  (opium).  Shiloh's  Cure  (heroin). 

Petit's  Eye  Salve  (morphine).  Tubercine  (opium). 

P>rou's  Injection  (morphine).  Hooper's      Anodyne;      the      Infant's 

Carney  Common  Sense  Cure   (morph-  Friend    (morphine). 

ine).  Pierce's  Smart  Weed   (opium). 

Habitina  (morphine).  Colwell's  Egyptian  Oil    (opium). 

Anglo-American  Catarrh  Powder;  Ag-  Maguire's    Compound    Extract    Benne 

new's  Powder  (cocaine).  (morphine). 

Captol  (chloral).  Dr.  Fahrney's  Teething  Syrup  (morph- 

Gowan's  Pneumonia  Cure   (opium).  ine). 

Dr.  James'  Soothing  Syrup  (heroin).  Jayne's  Expectorant  (opium). 

Mrs.       Winslow's      Soothing      Syrup  Taylor's  Sweet  Gum  and  Mullein  Com- 

( morphine).  pound  (morphine). 

Children's  Comfort  (morphine).  Victor  Lung  Syrup  (opium). 

D.  D.  D.  Remedy  (chloral).  Dr.      Moffett's      Teethina;      Teething 

Mexican  Oil  (opium).  Powders  (opium). 

One  Day  Cough  Cure  (morphine,  Caji-  Tucker's  Asthma  Cure   (cocaine). 

naMs  indica).  Rexal  Cholera  Cure  (opium). 

Tousley's  Sneezel ess  Snuff  (morphine).  Fruit-Lax  (morphine). 
Watkin's  Anodyne  (heroin). 
Dr.    Drake's   German   Croup   Remedy 

(opium). 

DANGER  OF  SOFT  DRINKS  CONTAINING  HABIT-FORMING  DRUGS. 

In  this  connection  attention  is  directed  to  the  danger  of  soft  drinks 
containing  caffeine,  extract  of  kola  nut,  and  extract  of  coca  leaf,  the 
active  principle  of  the  two  latter  being  cocaine.  According  to  Doctor 
Kebler,  see  Appendix,  there  are  now  nearly  one  hundred  different 
medicated  soft  drinks  on  the  market. 

These  beverages  are  extensively  advertised,  some,  in  fact,  as  head- 
ache remedies  and  nerve  tonics,  and  sold  at  nearly  every  soda-water 
fountain  or  as  carbonated  goods  in  all  parts  of  the  country  without 
the  slightest  warning  to  the  public  of  the  harmful  ingredients  con- 
tained therein.  We  restrict  the  use  of  coffee  and  tea  in  children 
and  delicate  nervous  individuals,  and  yet  these  same  persons  fre- 
quent the  soda  fountains,  regale  themselves  with  soft  drinks,  quite 
unconscious  of  their   contents,  experience  the  stimulating  and   re- 


REPORTS   OF   THE  PRESIDENT'S   HOMES   COMMISSION.  257 

freshing  effects  and  soon  fall  victims  to  the  habit,  so  that  even  "  Coca 
Cola  fiends  "  have  come  into  prominence.  We  have  seen  how  the 
opium  habit  may  be  acquired  by  the  use  of  the  various  proprietary 
or  secret  preparations  (pain  killers),  usually  employed  as  domestic 
remedies,  and  so  the  cocaine  habit  may  be  developed  by  the  use  of 
these  much-lauded  soft  drinks. 

It  is  a  significant  fact  that  Mr.  Vanzant,  the  special  police  officer 
charged  with  the  execution  of  the  pharmacy  law,  with  the  exception 
of  the  Chinese  opium  fiends,  has  never  encountered  other  foreigners 
who  are  addicted  to  the  drug  habit.  This  may  be  accounted  for  by 
the  fact  that  nowhere  is  the  habit  of  self-medication  with  secret  or 
proprietary  medicines  for  each  and  every  ailment  so  widespread  as 
in  this  country.  No  wonder  that  insanity  and  diseases  of  the  nervous 
system  are  on  the  increase,  and  that  the  physical,  moral,  and  mental 
wrecks  of  the  alcohol  and  drug  habit  continue  to  swell  the  number 
of  dependents  in  hospitals,  insane  asylums  and  other  public  insti- 
tutions. 

From  a  careful  analysis  of  the  evidence  it  is  apparent  that  the  sale 
of  habit-forming  drugs  is  still  carried  on  through  the  instrumentality 
of  (1)  unscrupulous  local  dealers,  (2)  depraved  and  unscrupulous 
local  physicians,  and  (3)  through  dealers,  physicians,  agents,  and 
peddlers  located  in  other  jurisdictions. 

The  writer  has  reached  the  conclusion  that  Major  Sylvester's  pro- 
posed amendment  to  the  present  law  will  not  prove  effective  unless 
a  law  is  enacted  permitting  the  revocation  of  a  license  to  physicians, 
dentists,  and  veterinarians  whenever,  in  the  judgment  of  the  court, 
such  persons  are  abusing  the  privilege  of  prescribing  these  drugs.  A 
law  should  likewise  be  enacted  regulating  the  transportation  of  habit- 
forming  and  poisonous  drugs  in  interstate  and  foreign  commerce,  as 
contemplated  by  House  Res.  21982,  introduced  by  Mr.  Mann,  May 
12,  1908. 

REMEDIAL  MEASURES  FOR  THE  VICTIMS  OF  THE  ALCOHOL  AND  DRUG  HABIT. 

The  reports  of  the  chief  of  police  show  that  during  the  five  years' 
period  ended  June  30,  1908,  there  were  27,985  arrests  for  intoxication 
in  the  District  of  Columbia,  an  average  of  5,596  per  annum.  Of 
these,  18,075  were  arrests  for  simple  intoxication,  and  8,288  arrests 
for  intoxication  and  disorderly  conduct.  There  being  no  law  against 
simple  intoxication,  those  detained  for  this  cause  are  released  by  the 
police  after  they  have  sobered  up.  Such  cases  are  taken  up  as  ob- 
structions and  for  their  own  security  and  welfare,  and  of  these  18,075 
cases  no  doubt  "  many  were  saved  from  injury,  robbery,  and  sickness, 
if  not  from  death."  In  spite  of  precautions  taken  by  the  police,  a 
number  of  deaths  from  acute  alcohol  poisoning  have  occurred  in 
police  cells,  indicating  the  necessity  of  greater  discrimination  in  the 
care  and  treatment  of  such  cases. 

There  were  1,622  arrests,  an  average  of  324  per  annum,  on  the 
charge  of  habitual  drunkenness,  and  these,  together  with  those 
charged  with  disorderly  conduct,  are  held  for  the  court,  and  many 
find  their  way  into  the  workhouse  or  jail.  It  is  lamentable  that  15 
of  the  675  arrests  of  persons  under  the  age  of  21  years  were  arrested 
as  "  habitual  drunkards." 

S.  Doc.  644,  60-2 ^18 


258 


REPOKTS  OF   THE  PRESIDENT  S  HOMES  COMMISSION. 


Nwnl)er  of  arrests  in  the  District  of  Columbia  for  intoxication,  and  intoxica- 
tion coupled  with  disorderly  conduct,  for  the  five  years  ended  June  SO,  1908. 


Under  21  years  of  age. 

Over  21  years  of  age. 

Male. 

Female. 

Wkite. 

Colored. 

Male. 

Female. 

White. 

Colored. 

1904. 

2 

60 
60 

2 

45 
17 

214 
2,978 
1,531 

12 
150 
201 

188 

2,457 

945 

38 

Intoxication 

4 
20 

19 
63 

671 

Intoxication  and  disorderly 

787 

1906. 

Habitual  drunkard    ...... 

3 

69 
69 

2 

47 
29 

1 
16 
56 

261 
3,265 
1,469 

13 

206 
198 

211 

2,674 

986 

63 

4 

16 

797 

Intoxication  and  disorderly 

681 

1906. 

Fahltnn.1   d"iTiVftTd  ,  ,  ^ 

1 

65 

44 

1 

37 
20 

272 
3.529 
1,518 

18 
241 
236 

227 

2,883 

976 

63 

Intoxication   .  ... 

9 
19 

27 
43 

887 

Intoxication  and  disorderly 

778 

1907. 

Habitual  drunkard 

4 

50 
51 

2 

27 
27 

2 

31 
49 

413 
3,521 
1,246 

25 

236 
182 

341 

2,870 
692 

97 

Intoxication 

8 
25 

887 

Intoxication  and  disorderly 

736 

1908. 

Habitual  drunkard 

Intoxication 

4 

50 
36 

1 

4 
18 

S 

29 
17 

2 

25 
36 

340 
3,395 
1,215 

S9 

251 
135 

278 

2,775 
684 

106 

871 

Intoxication  and  disorderly 

666 

647 

128 

305 

370 

25,167 

2,143 

19, 182 

8,128 

Doctor  Macatee's  investigation  shows  that  during  the  past  nine 
years  9,510  patients  were  treated  in  the  hospitals  of  the  city  of 
Washington  for  alcoholism;  409  for  delirium  tremens;  256  for  the 
opium  habit,  and  61  for  the  cocaine  habit;  the  majority  of  these  were 
treated  at  public  expense. 

All  investigation  of  the  records  of  the  Board  of  Charities  reveals 
the  fact  that  the  daily  average  number  of  insane  chargeable  to  the 
District  of  Columbia  has  increased  from  1,035  in  1901  to  1,317  in 
1908.  The  board,  recognizing  that  the  alcohol  and  drug  habit  are 
two  of  the  best  known  causes  of  insanity,  in  1907  made  provisions,  in 
connection  with  the  old  almshouse  building,  for  the  cure  and  treat- 
ment of  such  habitues  among  the  dependent  classes.  A  bill  intro- 
duced by  Senator  Gallinger,  April  6,  1908,  is  now  pending  before 
Congress,  making  habitual  drunkenness,  the  habitual  use  of  opium 
or  other  narcotic  drugs  a  misdemeanor,  punishable  by  a  fine  or  incar- 
ceration in  the  hospital  for  inebriates  for  not  longer  than  two  years. 
The  act  contemplates  a  rational  care  and  treatment  for  the  cure  of 
the  habit,  which  is  best  secured  by  a  good  dietetic  and  hygienic 
regimen,  followed  by  some  useful  occupation  as  soon  as  the  patients 
are  able  to  work,  so  as  to  make  them  self-supporting  during  the 
period  of  abstinence  and  restraint.  The  former  system  of  confining 
such  persons  in  the  workhouse  and  jail  is  cruel  and  wholly  ineffective. 

The  crying  need  for  compulsory  restraint  has  been  pointed  out  by 
the  chief  of  police  over  and  over  again,  and  the  appeal  for  humane 
and  scientific  treatment  of  husbands,  fathers,  brothers,  and  wives  is 


"RBPOBTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  259 

not  of  recent  date.  As  a  matter  of  f  act,<*  Congress,  in  an  act  approved 
March  30,  1876,  known  as  "An  act  to  incorporate  the  Washington 
City  Inebriate  Asyhim  in  the  District  of  Columbia,"  approved  the 
principle  of  compulsory  restraint  and  treatment  of  inebriates.  This 
act  provided  for  the  organization  of  a  private  institution  authorized 
to  receive  both  free  and  pay  patients,  and  provided  for  commitment 
by  court  to  said  institution.  *  *  *  Apparently  the  incorporators 
never  organized  the  institution  as  authorized  in  the  act. 

ADVERTISED    HABIT    CURES. 

It  is  high  time  that  some  rational  method  for  the  permanent  recla- 
mation of  these  unfortunate  victims  be  adopted  in  this  and  other 
communities.  As  it  is  now,  the  rich  and  poor  alike  fall  an  easy  prey 
to  advertising  charlatans,  who  profess  to  cure  the  drug  and  alcohol 
habit,  when  as  a  matter  of  fact  these  so-called  drug  cures  merely  ag- 
gravate the  habit  and  never  cure  it,  and  in  the  case  of  the  alcohol 
cures,  the  patients'  stomach  and  digestion  are  often  permanently  in- 
jured and  no  real  good  is  accomplished.  Mr.  Samuel  Hopkins  Ad- 
ams, in  Collier's  Weekly,  September  22,  1906,  published  a  list  of 
16  advertised  cures  for  the  opium  habit  when  in  each  case  the  remedy 
contained  morphine,  and  says: 

The  whole  purpose  is  to  substitute  for  the  slavery  to  the  drug  purchased  at 
the  corner  pharmacist,  the  slavery  to  the  same  drug  disguised,  purchased  at 
a  much  larger  price  from  the  "  doctor  "  or  "  institute  "  or  "  society."  It  was 
hoped  that  with  the  enactment  of  the  pure-food  law,  which  requires  that  the 
amount  of  habit-forming  drug  in  any  medicine  be  stated  on  the  label,  such 
nefarious  practices  would  cease.  Imagine  my  surprise  at  the  audacity  of  a 
firm,  when  shown .  by  Doctor  Kebler  a  preparation  known  as  "  Habitina," 
recommended  as  a  cure  for  all  drug  addictions,  etc.,  when  the  label  disclosed 
the  fact  that  1  ounce  of  the  solution  contains  24  grains  of  morphine. 

Mr.  Adams  mentions  a  remedy  procured  from  the  Rev.  W.  N. 
Richie,  D.  D.,  156  Fifth  avenue.  New  York,  which  contained  2.12 
grains  of  crystallized  morphine  per  dose;  the  ordinary  dose  for 
medicinal  purposes  is  from  one-eighth  to  one- fourth  of  a  grain.  No 
wonder  this  courageous  writer  speaks  of  the  opium,  morphine,  and 
cocaine  cure  quacks  as  the  "wreckers  who  lure  their  victims  to  de- 
struction by  false  signals."  Nor  are  we  surprised  that  one  of  these 
victims  wrote  to  Mr.  Adams : 

When  I  tried  to  stop  the  remedy  I  found  I  could  not  and  It  was  worse  than 
the  morphine  itself.  I  then  went  back  to  plain  morphine,  but  found  that  I  re- 
quired twice  as  much  as  before  I  took  the  cure.  That  is  what  the  morphine 
cure  did  for  me. 

In  the  appendix  will  be  found  Doctor  Kebler's  list  of  52  alleged 
cures  for  drug  and  liquor  habits.  As  an  analytical  chemist,  he  con- 
firms the  belief,  long  since  held  by  the  profession,  that  the  drug  cures 
in  almost  every  instance  contain  a  generous  proportion  of  an  opiate 
and  most  of  the  nostrums  for  the  cure  of  the  liquor  habit  contain  some 
nauseating  ingredients  or  slow  emetics.  The  object  of  the  latter 
treatment  is  in  most  cases  to  make  the  victim's  stomach  so  sensitive 
that  it  will  instantly  reject  anything  of  an  irritating  nature  like 
alcohol.    It  will  be  readily  conceded  that  such  treatment  is  of  no 

«  Extract  from  letter  of  the  Board  of  Charities  to  the  CJommlflsionerB,  February 
4,  1908. 


260  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

real  value  and  is  likely  to  produce  permanent  injury  of  the  stomach 
and  digestive  functions.  Mr.  Adams's  comments  in  Collier's  Weekly 
on  this  subject  are  very  much  to  the  point.  "The  Sunday  news- 
papers and  small  weeklies  teem  with  advertisements  of  drink  cures 
which  are  supposed  to  exorcise  the  alcoholic  craving  when  secretly 
given  in  the  tea  or  coffee.  Few  of  these  concoctions  can  be  described 
as  immediately  dangerous,  though  none  of  them  is  really  safe.  All  are 
swindles.  They  do  not  cure  the  drink  habit.  Once  in  a  while  some 
drunkard  will  succeed  in  breaking  his  fetters  synchronously  with 
the  taking  of  the  '  remedy,'  and  the  wcmderful  '  cure '  is  heralded 
to  the  world.  But  the  percentage  of  these  cures  is  so  small  as  to  be 
practically  negligible.  *  *  *  Speaking  of  the  safe  rule  to  follow 
in  the  cure  for  the  drug  and  alcohol  habit,  he  says : 

Reputable  sanitariums  there  are  in  plenty  for  this  purpose;  most  physicians 
know  of  them.  The  addict  who  can  not  be  cured  in  them  can  not  be  cured  any- 
where, and  might  better  buy  his  poison  at  the  regular  rate  than  at  a  fancy 
price  from  the  vicious  quacks  of  the  advertising  school. 

THE  HARMFUL  EFFECTS  OF  SO-CALLED  ETHICAL  PROPRIETARY  MEDICINES, 
ACETANILID,   ANTIPYRIN,   AND   PHENACETIN. 

HEADACHE  REMEDIES,   ETC. 

Before  considering  the  nostrum  evil  in  general,  attention  should  be 
invited  to  Doctor  Kebler's  excellent  unpublished  article  on  the  harm- 
ful effects  of  the  above  remedies  when  employed  promiscuously  and 
without  medical  supervision.  For  the  purpose  of  this  paper  it  is 
simply  necessary  to  state  that  these  preparations  were  used  at  one 
time  rather  extensively  by  physicians  for  the  reduction  of  tempera- 
ture in  fevers  and  for  the  relief  of  pain,  especially  in  neuralgia  and 
headaches.  The  profession,  however,  soon  learned  that  the  adminis- 
tration of  these  drugs  was  attended  quite  frequently  with  profound 
symptoms  of  depression  and  other  untoward  effects,  and  this,  together 
with  a  number  of  fatalities  incident  to  their  use,  resulted  in  a  gradual 
but  not  complete  discontinuance  of  the  drugs.  In  the  meantime,  how- 
ever, the  pain-relieving  properties  of  these  drugs  became  known  to  the 
laity,  and  they  are  extensively  used  in  their  original  form  for  the 
relief  of  headache  and  other  pains,  or  as  ingredients  of  many  adver- 
tised cures  for  headaches,  etc. 

According  to  Doctor  Kebler,  there  are  approximately  365  headache 
remedies  now  on  the  market,  and  the  list  is  by  no  means  complete; 
about  one-half  of  these  have  so  far  been  examined  by  the  Bureau  of 
Chemistry  under  the  pure  food  and  drugs  act.  (See  Appendix.) 
Among  these  is  the  remedy  known  as  Harper^s  "  Curf  orheadake  Brain 
Fude,"  which  acquired  recently  notoriety  in  the  local  courts,  and 
which,  according  to  the  Bureau  of  Chemistry,  contained,  among  other 
ingredients,  acetanilid  and  antipyrin.  In  regard  to  the  ridiculous 
claim  that  such  preparations  act  as  food  for  the  nerves  or  brain,  the 
judge  in  the  case  just  referred  to,  in  his  charge  to  the  jury,  said : 

If  that  word  "  brain  food,"  spelled  in  the  two  different  ways  that  it  is  spelled, 
would  convey  to  the  ordinary  citizen  the  idea  that  it  was  a  food  for  the  brain 
as  contradistinguished  from  the  idea  of  a  food  for  the  whole  body,  then  it  is — 
and  I  so  charge  you  in  this  first  prayer — misleading  and  therefore  a  violation 
of  the  law. 


REPORTS   OF   THE  PRESIDENT  S   HOMES   COMMISSION. 


261 


The  Department  of  Agriculture  has  carried  on  a  very  exhaustive 
investigation  into  the  poisonous  properties  of  these  drugs  for  the  very 
laudable  purpose  of  sounding  a  note  of  warning  as  to  the  injurious 
and  even  fatal  effects  which  may  follow  their  ill-advised,  prolonged, 
or  habitual  use.  The  following  table  shows  the  number  of  instances 
in  which  poisoning,  death,  or  habitual  use  has  been  known  to  result: 


Total  numher  of  cases. 


Poison- 
ing. 

Death. 

Habitual 
use. 

Acetanilid 

909 
592 
161 

31 

15 

8 

144 

7 

Acetphenetidin  (phenacetin) 

18 

Total 

1,665 

64 

169 

Of  this  total  number,  852  were  found  in  medical  literature  and  813 
were  reported  by  400  of  the  925  physicians  to  whom  letters  of  inquiry 
had  been  directed  by  the  department.     Doctor  Kebler  says : 

Granting  that  the  525  physicians  who  did  not  reply  had  no  cases  to  report, 
the  question  may  be  profitably  asked — if  925  physicians  have  observed  813  cases 
of  poisoning  by  these  drugs,  28  deaths  which  were  attributed  to  their  use,  and 
136  instances  of  habitual  use,  how  many  such  cases  have  in  all  probability  been 
observed  by  the  125,000  physicians  scattered  throughout  the  United  States? 

THYROID   EXTRACTS    IN    OBESITY   OR    ANTIFAT   CUKES. 

Doctor  Kebler,"  and  more  recently  Drs.  Reid  Hunt  and  A.  Seidell,^ 
of  the  Hygienic  Laboratory  of  the  Public  Health  and  Marine- 
Hospital  Service,  have  called  attention  to  the  frequency  with  which 
thyroid  preparations  are  being  used  in  the  antifat  nostrums.  As  in 
the  case  of  the  remedies  just  discussed,  so,  with  thyroid  extracts, 
have  physicians  become  extremely  cautious  in  their  employment. 
These  preparations  were  primarily  used  for  the  cure  of  goitre,  and, 
while  they  produced  a  marked  reduction  in  the  size  of  the  tumor,  it 
was  also  found  that  they  caused  a  marked  loss  in  bodily  weight, 
amounting  in  some  instances  from  2  to  11  pounds  a  week,  all  of 
which  naturally  suggested  their  employment  for  the  reduction  of 
obesity.  But  the  careful  observer  soon  found  that  these  results  were 
not  without  serious  risks  to  the  general  health,  and  practically 
abandoned  the  remedy  except  in  some  well-selected  cases.  The  manu- 
facturer of  proprietary  remedies  seized,  however,  very  promptly 
upon  the  opportunity  to  incorporate  what  must  be  considered  dan- 
gerous remedies  with  other  ingredients,  and  offered  them  as  "  Obes- 
ity Food,"  "Rengo  Fruit,"  "  Kellogg's  Obesity  Food,"  "Arbolum 
Mixture,"  "  Marmola,"  with  the  usual  assurances  of  being  scientific 
and  effective  preparations  for  the  reduction  of  fat.  Since  thyroid 
extract  is  characterized  by  Dr.  Reid  Hunt  as  "  the  most  powerful 
tissue-destroying  drug  known,"  the  effects  upon  the  unfortunate  vic- 
tims of  misplaced  confidence  can  be  imagined.  The  employment  of 
these  agents  for  this  purpose  is,  however,  of  such  recent  date  that  no 

•  "  Journal  A.  M.  A.,**  November  10,  1906. 
» **  Journal  A.  M.  A.."  October  24,  1908. 


262 

fatalities  have  been  reported.  We  know,  however,  that  several  fatal 
cases  were  reported  when  employed  under  the  supervision  of  com- 
petent physicians,  and,  in  November,  1906,  in  an  editorial  in  the 
"Journal  of  the  American  Medical  Association,"  the  danger  of 
"  organotherapy "  in  producing  arterial  degeneration  was  pointed 
out,  as  well  as  the  necessity  of  being  "  careful  in  the  application  of 
such  remedies,  and  especially  not  to  hand  over  the  employment  of 
them  too  freely  to  the  public  under  such  circumstances  that  they  will 
be  used  over  prolonged  periods  without  proper  safeguards  and  the 
careful  observation  of  a  trained  medical  mind." 

THE   NOSTRUM   EVIL   IN   GENERAL." 

Our  sociological  study  of  1,217  families  in  this  city  shows  that 
they  expended  $2,032.39  per  annum  for  patent  or  proprietary  medi- 
cines. The  annual  expenditure  in  the  United  States  has  been  esti- 
mated to  be  not  less  than  $62,000,000.  The  far-reaching  consequences 
of  this  traffic,  which  impoverishes  the  health  and  depletes  the  pocket- 
book  of  a  large  class  of  persons,  has  been  made,  in  a  fearless  and  most 
commendable  manner,  the  subject  of  popular  education,  notably  by 
the  Ladies  Home  Journal,  Collier's  Weekly,  the  Journal  of  the  Amer- 
ican Medical  Association,  Pharmaceutical  Journal,  and  by  Prof. 
Harvey  W.  Wiley  and  his  associate.  Dr.  Lyman  F.  Kebler,  of  the 
Bureau  of  Chemistry,  United  States  Department  of  Agriculture. 

The  writer  has  long  since  taken  a  keen  interest  in  the  subject  be- 
cause as  a  sanitarian  he  felt  convinced  that  the  harmful  effects  of 
this  nefarious  business  upon  the  health  and  general  welfare  of  the 
community  have  never  been  sufficiently  emphasized,  even  by  the 
medical  profession.  The  American  Medical  Association  adopted 
the  following  principles  over  fifty  years  ago :  "  It  is  equally  deroga- 
tory to  professional  character  for  physicians  to  hold  patents  for  any 
surgical  instruments  or  medicines;  to  accept  rebates  on  prescriptions 
or  surgical  appliances;  to  assist  unqualified  persons  to  evade  legal 
restrictions  governing  the  practice  of  medicine,  or  to  dispense  or  pro- 
mote the  use  of  secret  medicines,  for  if  such  nostrums  are  of  real 
efficacy,  any  concealment  regarding  them  is  inconsistent  with  benefi- 
■  cence  and  professional  liberality ;  and  if  mystery  alone  can  give  them 
public  notoriety,  such  craft  implies  either  disgraceful  ignorance  or 
fraudulent  avarice.  It  is  highly  reprehensible  for  physicians  to  give 
certificates  attesting  the  efficacy  of  secret  medicines  or  other  sub- 
stances used  therapeutically." 

No  effective  work  in  the  propaganda  for  reform  in  proprietary 
medicines  was  done,  however,  until  the  creation  of  the  Council  on 
Pharmacy  and  Chemistry  in  the  American  Medical  Association  in 
February,  1905.  This  council  has  rendered,  and  will  continue  to 
render,  most  meritorious  services  to  the  cause  of  humanity.  To  show 
the  enormity  of  the  traffic  and  corresponding  dangers,  the  following 
statement  (the  data  to  December  31,  1900,  having  been  originally 
collected  for  my  "  Oration  on  State  Medicine,"  delivered  before  the 
American  Medical  Association  June  8,  1901),  is  herewith  presented: 

•The  author  is  indebted  to  Dr.  M.  Q.  Motter  for  valuable  references  to  the 
literature  of  the  subject 


EEPORTS   OF   THE  PRESIDENT  S  HOMES   COMMISSION. 


263 


Patents  issued  hy  the  United  States  Patent  Office, 


To  Dec. 
31, 1900. 

From  Jan. 

1,  1901,  to 

Oct.  31, 

1908. 

Disinfectants .                      .           

321 
250 

48 
180 
376 

56 
371 

78 

9(V> 

Extracts 

65 

Hair  dyes  and  tonics 

7 

Insecticides.  .        

64 

58 

Plaster 

19 

Topical  remedies 

35 

Veterinarv 

10 

Total 

1,680 

460 

Trade-marks  issued: 

Drugs  and  chemicals 

319 
5,974 

Medical  compounds 

Under  date  of  November  17,  1908,  the  Commissioner  of  Patents  in- 
forms me  that  trade-marks  have  been  reclassified,  and  since  January 
1,  1901,  there  have  been  issued  in  subclass  No.  6,  chemicals,  medicines, 
and  pharmaceutical  preparations,  approximately  2,105  trade-marks. 
This  means  that  up  to  October  31,  1908,  the  office  has  issued  2,140 
patents  and  8,398  trade-marks  on  drugs,  chemicals,  and  medical  com- 
pounds. 

By  the  term  patent  medicine,  as  properly  employed,  it  must  be  un- 
derstood that  the  composition  is  known  and  can  be  seen  at  the  Patent 
Office.  The  proprietary  medicine  is  a  secret  preparation  protected 
by  a  trade-mark  and  hence  preferred  by  the  owner,  but  both  are 
vaguely  termed  by  the  public  patent  medicines. 

The  proprietary  medicines  are  subject  to  the  control  of  the  state 
authorities  and,  if  containing  alcohol  in  sufficient  quantity  to  be  in- 
toxicants, are  subject  to  internal-revenue  laws.  But  up-  to  the  enact- 
ment of  the  pure  food  and  drugs  law,  June  30, 1906,  nothing  was  done 
to  control  the  sale  of  secret  remedies  and  medicinal  preparations  con- 
taining habit- forming  drugs,  the  composition  of  which  need  not  even 
be  disclosed  to  the  Patent  Office. 

Fortunately,  section  8  of  the  act  referred  to  provides  that  an  article 
shall  be  deemed  to  be  misbranded  *  *  *  if  the  package  fails  to 
bear  a  statement  on  the  label  of  the  quantity  or  proportion  of  any  al- 
cohol, morphine,  opium,  cocaine,  heroin,  alpha  or  beta  eucaine,  chloro- 
form, cannabis  indica,  chloral  hydrate  or  acetanilid  or  any  derivative 
or  preparation  of  any  such  substances  contained  therein.  In  conse- 
quence of  this  very  wise  provision  of  the  law  we  are  now  enabled  to 
estimate  the  enormity  of  the  harm  which  must  inevitably  result  from 
promiscuous  use  of  such  preparations. 

A  most  excellent  report  on  "  secret  drugs,  cures  and  foods  "  was 
presented  by  Special  Commissioner  Octavius  C.  Beale  to  the  Parlia- 
ment of  the  Commonwealth  of  Australia,  August  8,  1907,  in  which  he 
discusses  the  subject  under  six  headings,  viz :  Prevention  of  concep- 
tion and  feticide;  (2)  infanticide  and  infantile  mortality;  (3)  injury 
and  death  to  the  adolescent;  (4)  injury  and  death  to  adults;  (5)  ad- 
vertisements; (6)  legislation.  In  view  of  the  importance  of  the  sub- 
ject, it  is  deemed  desirable  to  present  here  a  brief  summary  of  the 


264  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

most  important  facts  collected  by  this  painstaking  investigator,  not 
only  in  Australia,  but  also  in  the  United  States,  Canada,  Great  Brit- 
ain, Germany,  and  France. 

PREVENTION    OF    CONCEPTION    AND    FETICIDE REGULATION    OF    FAMILIES. 

In  this  section  Commissioner  Beale  writes : 

The  practice  of  interference  with  the  sexual  function  is  so  common  and  the 
knowledge  of  it  so  universal  that  it  would  be  thinnest  hypocrisy  upon  the  part 
of  any  grown  person  to  pretend  that  modesty  may  be  shocked  at  considering 
its  causes  and  consequences.  The  disastrous  effects  upon  men  and  women  are 
set  forth  in  plain  and  decent  language  in  the  report  of  the  New  South  Wales 
royal  commission  upon  the  decline  in  birth  rate  and  upon  mortality  of  children, 
which  it  would  be  well  to  reproduce  by  another  inquiry  over  a  wider  sphere, 
or  indeed  merely  to  reprint  for  broadest  distribution.  Just  because  deception 
and  falsehood  are  widespread  there  is  occasion  to  confront  them  by  candid 
truth.  *  *  *  Before  me  is  a  co])y  of  the  second  volume.  *  *  *  There, 
upon  page  after  page,  are  photographs  of  the  advertisements  of  obscene  crea- 
tures who  corrupt  society  at  its  core  and  live  like  larvae  upon  their  own  poison 
and  the  corruption  it  causes.  The  announcements  appear  to-day  just  as  before, 
only  more  of  them.  To  debauch  and  degrade  humanity  is  a  profitable  trade. 
On  those  pages  are  also  photographs  of  numbers  of  preparations  to  prevent 
births,  of  contrivances  toward  obscene  practices.  *  *  *  There  is  only  one 
remedy — morality  by  act  of  Parliament,  enforced  by  severe  penalties.  *  *  ♦ 
No  attempt  will  be  made  to  give  a  comprehensive  statement  of  the  means 
adopted  to  induce  miscarriage.  The  unnatural  practice  is  assisted  by  the  free 
sale  of  drugs,  often  at  exorbitant  prices,  under  proprietary  names.  These  are 
openly  advertised  in  Anglo-Saxon  countries,  which  differ  therein  from  one 
another  only  in  degree,  the  names  and  descriptions  of  the  drugs  being  well 
understood  by  dealers  and  users. 

In  order  amply  to  elucidate  the  subject  of  criminal  abortion  by 
drugs  Mr.  Beale  quotes  the  following  extract  from  Taylor's  "  Medi- 
cal Jurisprudence  "  (Vol.  II,  p.  166,  et  seq.) : 

The  following  generalization,  which  is  strictly  warranted  by  facts,  conveys 
a  warning  to  would-be  abortionists,  whether  professional  or  habitual,  or  lay 
and  occasional.  There  is  no  drug,  and  no  combination  of  drugs,  which  will, 
when  taken  by  the  mouth,  cause  a  healthy  uterus  to  empty  itself,  unless  it  be 
given  in  doses  sufficiently  large  to  seriously  endanger  by  poisoning  the  life  of 
the  woman  who  takes  it. 

In  this  country,  as  explained  by  Doctor  Kebler,  the  publication  of 
advertising  matter  inviting  attention  to  means  whereby  conception 
can  be  prevented  or  abortion  produced  is  specifically  prohibited  by 
law.  In  order  to  circumvent  the  law,  however,  the  advertising  litera- 
ture is  so  framed  as  to  clearly  indicate  the  purpose  for  which  the 
preparation  is  intended,  such  as  "  French  Female  Pills,  a  safe,  certain 
relief  for  suppressed  menstruation.  Never  known  to  fail.  Safe, 
sure,  speedy,"  etc. 

Vital  statistics  show  that  the  birth  rate  in  England  has  dropped 
from  34.3  per  1,000  in  1878  to  28  per  1,000  in  1901 ;  in  South  Aus- 
tralia from  39  in  1885  to  24  in  1906 ;  in  Germany  from  40.4  in  1881 
to  35.3  in  1894.  The  great  decline  in  the  birth  rate  in  France  has 
been  a  matter  of  much  comment,  and  the  latest  statistcis  show  little 
or  no  increase  in  the  French  population.  The  birth  rate  of  Paris, 
already  low  in  1881,  has  further  declined  from  23.3  to  16.6  in  1894. 
We  have  no  reliable  birth  rates  for  the  United  States  as  a  whole. 
The  census  statistics  of  1900  show  that  the  birth  rate  has  increased 
from  26.9  in  1890  to  27.2  per  1,000  of  the  mean  population  in  1900. 
Harrington,  in  speaking  of  the  decline  in  birth  rates  in  foreign  coun- 


REPORTS   OP   THE  PRESIDENT'S  HOMES   COMMISSION.  265 

tries,  says  among  the  descendents  of  the  original  colonists  and  earlier 
immigrants  the  same  decline  is  most  evident.  *  *  *  In  Massa- 
chusetts the  statistics  of  1898  show  that  the  greatest  proportion  of 
the  number  of  births  belongs  to  the  foreign  born,  the  children  of 
native  parentage  on  both  sides  representing  32.36,  those  of  mixed 
parentage  19.42,  and  those  of  foreign-born  parentage  48.22  per  cent 
of  the  total  births.     The  crude  birth  rate  was  27.37. 

Mr.  Roosevelt  is  quoted  to  have  said  that  "  there  are  fewer  descend- 
ants of  the  revolutionary  forefathers  living  to-day  than  there  were 
fifty  years  ago.  We  must  either  alter  our  ways  or  we  must  make 
way  lor  the  other  races — Asiatic  or  whatever  they  are — that  will 
certainly  replace  us."  Every  thoughtful  physician  and  layman  rea- 
lizes that  the  declining  birth  rates  are  chiefly  the  effects  of  vice,  un- 
natural interference,  and  actual  homicide. 

Dr.  H.  S.  Pomeroy,  of  Boston,  over  twenty  years  ago  presented  the 
moral,  social,  and  medical  aspects  of  prevention  in  his  book,  "  The 
Ethics  of  Marriage,"  which  evoked  the  unqualified  approval  of  the 
late  Mr.  W.  E.  Gladstone.  The  President  of  the  United  States  has 
uttered  notes  of  warning  on  the  "  race  suicide  problem,"  and  Profes- 
sor Emmet,  the  eminent  gynecologist,  asks : 

Can  anyone  accustomed  to  treating  the  diseases  of  women  say  in  truth  the 
statement  is  exaggerated  that  we  can  see  on  any  one  day  more  sorrow  and 
misery  resulting  from  the  abuse  of  the  married  state  than  would  be  found  in  a 
month  from  uncomplicated  child-bearing? 

Doctor  Kebler  has  furnished  me  with  a  list  of  51  so-called  female 
pills  or  regulators  advertised  in  this  country.  ( See  appendix. )  While 
quite  a  number  may  act  as  abortifacients,  the  majority  are  worthless 
and  frauds  pure  and  simple.  Among  a  number  of  fraud  orders  issued 
by  the  Postmaster-General  during  the  past  two  years  the  following 
transcript  from  the  records  of  the  Assistant  Attorney-General's 
office,  submitted  May  29,  1908,  in  the  case  of  Mrs.  A.  Kirk  and  the 
Reliable  Remedy  Company,  2317  Brooklyn  avenue  and  Eighteenth 
and  Grove  streets,  Kansas  City,  Mo.,  will  be  of  interest: 

It  will  be  remembered  that  on  October  29,  1907,  a  fraud  order  was  issued 
against  the  Doctor  Price  Remedy  Company,  its  officers  and  agents  as  such, 
and  Mrs.  J.  Linson  and  Mrs.  A.  Miller,  2904  Woodland  avenue,  Kansas  City, 
Mo.  The  scheme  against  which  the  order  was  directed  was  conducted  by  a 
man  by  the  name  of  Arthur  P.  Miller,  and  involved  the  sale  through  the  mails, 
by  means  of  advertisements  in  newspapers  and  circulars,  of  pills  for  women 
to  act  as  abortifacients,  which  pills  in  fact  were  worthless  for  the  purpose, 
as  was  well  known  to  Miller.  Miller  was  indicted  November  5,  1907,  in  con- 
nection with  the  above  case,  and  on  the  following  day  he  entered  a  plea  of 
guilty  and  was  sentenced  to  a  term  of  six  months  in  the  Bates  County  jail 
at  Butler,  Mo.,  and  to  pay  the  costs  of  prosecution. 

A  report  has  now  been  received  from  the  inspector  at  Kansas  City,  Mo.,  that 
Miller,  as  soon  as  the  fraud  order  was  issued  October  29,  moved  his  desk  into 
the  real  estate  office  of  a  man  by  the  name  of  William  Abel,  Eighteenth  and 
Grove  streets,  Kansas  City,  Mo.,  where  the  two  continued  the  business  until 
Miller  pleaded  guilty,  and  that  during  the  time  he  was  serving  the  sentence  his 
wife  conducted  the  business  for  him  with  Abel.  *  *  *  In  order  to  receive 
the  mail,  these  parties  advertised  under  the  fictitious  names  of  Mrs.  A.  Kirk, 
2317  Brooklyn  avenue,  which  is  the  residence  of  Abel  and  Miller,  and  to  those 
persons  who  replied  to  their  advertisements  they  sent  circulars  under  the  name 
of  Reliable  Remedy  Company,  Eighteenth  and  Grove  streets,  which  was  the 
office  of  Abel,  in  which  circulars  the  addressee  was  solicited  to  remit  $2  for 
pills,  which  were  described  in  language  calculated  to  cause  the  reader  to  believe 
they  would  act  as  abortifacients.  *  *  *  The  inspector  says  that  about  25 
letters  are  being  received  dailj  hj  those  persons  in  connection  with  the  scheme. 


266  RBPOBTS  OF  THE  PRESIDENT'S  HOMES  COMMISSION. 

The  inspector  states  that  he  presented  the  above  facts  to  the  United  States 
attorney,  who  caused  the  matter  to  be  presented  to  the  grand  jury,  which  re- 
turned an  indictment  against  both  Miller  and  Abel  on  May  5,  to  which  indict- 
ments these  parties  have  entered  a  plea  of  not  guilty  and  gave  bond  of  $1,000 
each  to  stand  trial.  *  *  *  Fraud  order  issued  May  29,  1908.  Abel  was 
sentenced  September,  1908,  to  pay  $25  and  costs. 

INFANTICIDE  BY  SYSTEMATIC  DRUGGING  OP  CHILDREN. 

In  discussing  the  subject  of  infant  mortality  in  relation  to  the  occu- 
pation of  women,  the  influence  of  ignorance  and  poverty  has  been 
emphasized,  and  we  quoted  Sir  John  Simon,  on  page  78,"  to  the  effect 
that  "  infants  who  should  be  at  the  breast  are  improperly  fed  or 
starved,  or  have  their  cries  of  hunger  and  distress  quieted  by  those 
various  fatal  opiates  which  are  in  such  request  at  the  centers  of  our 
manufacturing  industry."  We  have  also  referred  to  the  injury  done 
by  abnormal  cow's  milk  and  the  injurious  quality  of  certain  proprie- 
tary and  other  artificial  foods.  But  when'  we  contemplate  the  fright- 
ful mortality  in  illegitimate  children,  and  of  the  stillbirths,  especially 
in  illegitimate  offsprings,  we  may  well  apprehend  that  this  extraor- 
dinary destruction  of  life  is  induced  not  only  by  ignorance  or  poverty, 
but  also  by  crime. 

Of  the  66,808  births  in  Washington  from  1879-95,  37,781  were 
white  and  29,127  colored,  with  1,136  illegitimate  births  in  the  white 
race  and  6,706  in  the  colored  element.  Of  the  7,249  stillbirths  in  this 
city  during  the  same  period  2,750  were  white  and  4,449  were  colored ; 
of  this  number  2,053  were  illegitimate,  307  or  15.1  per  cent  were  white 
and  1,746  or  84.9  per  cent  were  colored. 

In  this  connection  it  is  desirable  to  point  out  the  serious  conse- 
quences of  the  systematic  drugging  of  children  by  "  soothing 
syrups,"  "  teething  syrups,"  "  children's  comfort,"  "  The  infant's 
friend,"  etc.  Doctor  Kebler  has  furnished  me  with  a  list  of  six  such 
compounds,  all  containing  opium  or  morphine,  not  to  mention  the 
numerous  cough  and  croup  remedies  in  the  market.  Nearly  every 
one  is  familiar  with  "  Mrs.  Winslow's  soothing  syrup ;"  it  contains 
morphine ;  so  does  "  Doctor  Fahrney's  teething  syrup,"  for,  according 
to  Doctor  Kebler,  the  label  declares  each  ounce  contains  alcohol,  9  per 
cent ;  morphine,  one-seventh  grain ;  chloroform,  two-thirds  of  a  minim  ; 
combined  with  seven  other  articles.  "  For  babes.  A  sure  remedy 
for  all  ailments  incident  to  babes  from  1  day  old  to  2  or  3  years; 
*  *  *  contains  nothing  injurious  to  the  youngest  babe  and  if 
given  in  proper  dose  will  always  relieve."  .Elsewhere  upon  the  label 
occurs  the  following  statement :  "  Mothers  need  not  fear  giving  this 
medicine  to  the  youngest  babe,  as  no  bad  results  come  from  the  con- 
tinued use  of  it.  Many  children  have  taken  2  and  3  dozen  bottles 
and  to-day  are  hale  and  hearty  boys  and  girls."  This  language  shows 
on  the  face  of  it  that  the  manufacturer  knows  full  well  that  the  drug 
is  dangerous.  It  should  be  known  that  children  are  especially  sus- 
ceptible to  the  toxic  effects  of  opium  and  its  preparations.  In  De- 
cember, 1905,  a  coroner's  jury  in  Baltimore  warned  the  public  not  to 
use  "  Kopp's  baby  friend,"  on  account  of  the  death  of  a  white  in- 
fant, aged  3  months  and  14  days,  who  had  been  given  this  prepara- 
tion by  his  mother  while  suffering  from  indigestion.     The  evidence  at 

•  Kober's  Industrial  Hygiene. 


BEPOETS   OF   THE  PRESIDENT  S  HOMES   COMMISSION. 


267 


the  inquest,  according  to  the  district  attorney,  showed  that  not  only 
this  child,  but  probably  three  others  in  the  neighborhood,  had  died 
recently  from  the  use  of  patent  medicines  administered  to  them.  The 
Journal  of  the  American  Medical  Association,  February  9,  1907, 
reports  the  death  of  twin  children  6  weeks  old  in  New  Castle,  Pa., 
caused,  according  to  Doctors  Cooper  and  Warner,  by  "  Kopp's  baby 
friend."  The  parents  gave  it  according  to  the  directions  accompany- 
ing the  bottle — 6  drops  every  two  or  three  hours  to  keep  the  infant 
from  crying.  The  children  were  not  sick ;  they  lived  about  one  day 
after  beginning  to  take  the  medicine.  When  Doctor  Warner,  the 
attending  physician,  saw  them,  they  were  in  the  last  stage  of  opium 
poisoning.  They  had  not  been  given  any  other  medicine.  In  the 
same  issue  of  the  Journal  are  the  reports  of  the  death  of  a  child 
aged  10  months  from  "  Mrs.  Winslow's  soothing  syrup,"  another  death 
in  a  child  from  the  effects  of  "  Monell's  teething  syrup,"  and  still 
another  from  the  effects  of  "  Rex  cough  syrup."  Space  will  not  per- 
mit the  presentation  of  other  cases  or  to  point  out  the  extreme  danger 
which  lurks  in  many  of  the  cough,  colic,  and  diarrhea  mixtures  and 
other  proprietary  remedies  which  have  killed  children  and  adults  and 
yet  are  unblushingly  advertised  as  safe  and  harmless  for  babes. 

Every  one  at  all  familiar  with  the  subject  knows  how  frequently 
nurses  have  to  be  discharged  for  "  doping  "  infants,  and  the  fact  that 
44  children  under  5  years  of  age  have  perished  in  this  city  during  the 
last  10  years  from  accidental  poisoning  is  sufficient  indication  of  the 
dangers  attending  the  promiscuous  use  of  poisonous  drugs. 


DIPHTHERIA    CURES. 

Doctor  Kebler  has  furnished  a  list  of  10  advertised  diphtheria 
cures.  In  view  of  the  fact  that  diphtheria  antitoxin  is  the  only 
reliable  remedy  in  this  disease  there  can  be  no  question  that  recourse 
to  advertised  cures  is  fraught  with  danger  to  the  child.  The  death 
rate  from  diphtheria  and  croup  in  1890  was  97.7  per  100,000;  in 
1900  it  was  only  45.2,  a  decrease  of  52.5  per  cent.  This  splendid  gain 
is  almost  entirely  due  to  the  use  of  antitoxin.  The  average  diphthe- 
ria mortality  where  antitoxin  was  used  in  1902  was  6.48  per  cent 
and  where  not  used  it  was  32.5  per  cent.  The  earlier  the  antitoxin 
is  employed  the  lower  are  the  death  rates.  The  mortality  in  children 
when  used  upon  the  first  day  was  1.45  per  cent,  but  when  used  later 
than  the  fourth  day  it  rose  to  14.49  per  cent. 

ADVERTISED    DIPHTHERIA    CUBES. 


Hesperian  Tonic,  Dr.  J.  W.  Roberts. 
Cure  for  Diphtheria,  etc. 

Humbug  Oil.     Cures  Diphtheria. 

Colwell's  Egyptian  Oil.  Dr.  Colwell's 
Magic  Egyptian  Oil,  cures  diph- 
theria, etc. 

Hamlin's  Wizard  Oil.  Cures  rheuma- 
tism, diphtheria,  etc. 

Dr.  Winchell's  Teething  Syrup.  A  cer- 
tain preventive  of  diphtheria. 

Wizard  Oil. 


Dr.  Shoop's  Diphtheria  Remedy.  For 
the  relief  and  cure  of  diphtheria. 

Gar-Gol.  An  absolute  specific  *  *  ♦ 
for  all  kinds  of  sore  throat.  Pre- 
ventive of  diphtheria. 

Indian  Rattle  Snake  Oil.  We  guaran- 
tee a  cure  for  ♦  *  ♦  diphtheria 
and  catarrh. 

Vapo  -  Cresoline.  "Cures  while  you 
sleep "  whooping  cough,  *  *  * 
diphtheria,  catarrh. 


268  EEPOKTS   OF   THE   PRESIDENT'S   HOMES   COMMISSION. 

INJURY  AND  DEATH  TO  THE  ADOLESCENT. 

In  this  section  Mr.  Beale  considers  the  exposure  of  the  young  to 
demoralization  and  even  to  debauchery  by  (a)  the  sale  of  intoxicants 
known  as  "bracers,"  which  are  disguised  alcoholics;  (&)  by  prepara- 
tions of  cocaine,  of  acetanilid,  of  sulfonal,  and  other  synthetic  de- 
pressants, of  opium  (to  a  much  less  extent);  (c)  by  compounded 
drugs  supposed  to  excite  sexual  desire;  (d)  by  preparations  intended 
to  prevent  conception  or  to  induce  abortion;  and,  finally,  (e)  by  the 
sale  of  certain  things  manufactured  in  Europe  which  are  designed 
and  sold  for  the  sole  purpose  of  nameless  and  unnatural  vices. 

The  subject  of  "  bracers  "  has  already  been  discussed  in  connection 
with  the  alcohol  habit.  Those  desiring  additional  information  as 
to  their  general  composition  and  effects,  not  infrequently  seen  in 
innocent  women  and  clergymen,  can  do  so  by  consulting  the  pages 
of  "  Collier's  Weekly "  for  October,  1905,  or  Mr.  Beale's  report, 
pages  90-94.  Dr.  J.  D.  Morgan  informs  me  of  a  recent  case  of 
alcoholic  multiple  neuritis  in  a  most  estimable  lady  who  had  taken 
Peruna  as  a  tonic 

We  have  already  discussed  the  cocaine  and  drug  habit  and  the 
shameful  traffic  in  lost-manhood  restorers. 

It  is  impossible,  in  the  scope  of  this  article,  to  give  an  adequate 
conception  of  the  enormity  of  the  nostrum  evil.  Some  idea  may  be 
formed  by  a  perusal  of  the  431  pages  of  Mr.  Beale's  report  and  an 
inspection  of  the  storerooms  of  the  Division  of  Drugs  of  the  Bureau 
of  Chemistry,  United  States  Department  of  Agriculture,  where  thou- 
sands of  preparations  may  be  found,  not  one-tenth  of  which  have  been 
analyzed  for  lack  of  laboratory  force.  And  yet  the  end  is  not  in  sight, 
but  the  supply  is  increased,  as  will  be  seen  by  reference  to  the  sta- 
tistics of  the  Patent  Office,  p.  263,  at  the  rate  of  about  200  a  year.  "A 
most  able  and  veracious  physician  has  truly  asserted  that  quackery 
has  destroyed  more  in  this  country  (Great  Britain)  than  the  sword, 
famine,  and  pestilence  united,  and  never  was  there  a  period  in  the 
history  of  British  medicine  at  which  the  force  and  truth  of  this 
opinion  was  more  obvious  than  at  this  day."  (Cited  by  Beale  from 
the  "Lancet,"  London,  June,  1906,  p.  1886.)  The  Standard  Dic- 
tionary defines  a  quack  as  a  pretender  and  quotes  the  following : 

South  Sermons,  Volume  II,  Sermon  XXX,  page  133:  "Quacks  and  mounte- 
banks are  doubtless  a  very  dangerous  sort  of  men — they  are  both  of  them  always 
very  large  in  pretense  and  promise,  but  short  in  performance  and  generally 
fatal  in  their  practice." 

Dr.  M.  A.  Clark,  in  a  recent  article  on  quacks,"  quotes  Steele  in  his 
"  Spectator  "  of  July,  1712,  as  saying  : 

Quack  doctors  who  publish  their  great  abilities  in  little  green  billets,  distrib- 
uted to  all  who  pass  by,  are  to  a  man  impostors  and  murderers.  I  doubt  not 
but  that  the  editors  of  our  great  newspapers  of  to-day  would  voice  the  same 
sentiment,  and  yet  we  find  these  journals  full  of  advertisements  of  quacks  and 
quack  medicines. 

OONSUMPnON   CURES. 

Doctor  Kebler  has  furnished  me  with  a  list  of  35  remedies  adver- 
tised for  the  prevention  and  cure  of  consumption.  Many  of  these 
preparations  contain  drugs  which  enslave,  but  the  chief  transgression 

•Atlanta  Joornal  Record  of  Medicine,  October,  IOCS. 


REPORTS   OF   THE  PRESIDENT  S  HOMES   COMMISSION. 


269 


lies  not  as  much  in  their  composition  "  as  in  the  fraudulent  methods 
used  in  their  exploitation,  such  as  symptom  blanks  and  mystic  and 
misleading  statements  and  false  claims  made  in  the  advertising  litera- 
ture." The  medical  profession  knows  that  there  is  no  specific  remedy 
for  the  disease  in  any  of  its  stages.  It  is  also  well  known  that  no 
germicide,  whether  taken  internally  or  inhaled,  which  would  kill  the 
tubercle  bacilli,  could  be  administered  without  serious  danger  to  the 
patient.  It  is  also  well  known  that  good  food,  pure  air,  and  a  rational 
hygienic  regimen  offer  the  best  chances  for  recovery,  and  that  patients 
wlio  resort  to  all  sorts  of  quack  remedies  in  the  early  stages  of  the 
disease  deprive  themselves  of  the  most  favorable  opportunity  for  a 
permanent  cure.  It  is  true  the  excuse  given  by  many  is  inability  to 
pay  a  doctor  or  druggist,  but,  as  a  matter  of  fact,  no  person  belonging 
to  the  dependent  classes  need  ever  go  without  the  most  skilled  medical 
care  and  treatment  in  connection  with  our  dispensaries  and  hospitals. 
I  have  never  known  a  reputable  physician  to  decline  to  lend  a  helping 
hand  in  directing  such  patients  into  the  proper  channels.  One  of  the 
interesting  features  in  connection  with  the  alleged  consumption  cures 
is  that  special  attention  is  given  to  the  dietetic  and  hygienic  regimen, 
which  is,  after  all,  the  fundamental  basis  of  success  and  can  be  had 
free  as  a  matter  of  public  education.  Among  the  remedies  extensively 
advertised  is  "  Tuberculozyne,"  which  is  claimed  as  having  killed  the 
consumption  germs,  and  that  all  trace  of  the  disease  in  blood  and 
tissue  was  destroyed."  Doctor  Kebler  might  have  added  "  Liquozone," 
which  in  addition  to  consumption  is  alleged  to  be  a  cure  for  36  other 
diseases  from  asthma  down  to  tumors  and  ulcers. 

Doctor  Kebler's  list  of  remedies  advertised  for  the  prevention  or 
cure  of  consumption  is  as  follows: 


Acker's  English  Remedy.  (?) 

Allen's  Lung  Balsam.  (?) 

Ayer's  Cherry  Pectoral. 

Ballard's  Horehound  Syrup. 

Birch  Mountain  Tea. 

Dr.  Bull's  Cough  Syrup. 

Chamberlain's  Cough  Remedy. 

H  and  N  Consumption  Cure. 

Hickory  Bark  Cough  Remedy. 

Hoff' s  Consumption  Cure. 

Dr.  King's  New  Discovery. 

Lung-Germine. 

Mrs.  Wesley  Magg's  Consumption  Cure. 

Mizpah  Cure. 

Peruna. 

Phoric  Electric  Method. 

Piso's  Cure. 

Richardson's  B  Z  Lung  Tonic. 

Roger's  Compound  Syrup  of  Liverwort, 

Tar  and  Canahalagua. 
Severas  Lung  Balsam.  (?) 


Eckman's  Alterative. 

Elchert's  Cold  and  Consumption  Cure. 

Father  John's  Medicine. 

Foley's  Honey  and  Tar. 

Fourneir's  Throat  and  Lung  Remedy. 

Germicidal  Vapor  Inhalation  Treat- 
ment.    Dr.  Anderson. 

Shiloh's  Consumption  Cure. 

Dr.  Stevens'  East  India  Consumption 
Cure. 

Tuberculoids. 

Vanderpool's  Consumption  Cure, 

Victor's  Lung  Syrup.  (?) 

Vinol. 

Virgin  Oil  of  Pine.  Leach  Chemical 
Co. 

Wilson's  Preparation  of  Hypophos- 
phites  and  Blodgetti. 

Yonkerman  Consumption  Cure,  "  Tu- 
berculozyne." 


ASTHMA  AND  HAT  FEVER  CURES. 

The  following  is  Doctor  Kebler's  account  of  this  class  of  secret 
remedies : 

These  nostrums  are  usually  sold  over  the  counter.  A  few  of  them,  however, 
can  only  be  obtained  from  the  producer  direct.  As  an  example  of  the  latter 
class  may  be  mentioned  Tucker's  Asthma  Specific.  This  preparation,  which  is 
widely  advertised  throughout  the  country  and  enjoys  a  large  sale,  consists  of 


270 


REPORTS   OF   THE  PRESIDENT  S  HOMES  COMMISSION. 


a  small  bottle  of  medicine  and  a  spray  atomizer.  The  price  of  tlie  "  treatment " 
is  $12.50.  Analysis  of  a  sample  of  the  medicine  disclosed  the  presence  of 
cocaine.  The  remedy  should  therefore  be  a  good  "  repeater."  Additional  sup- 
plies of  the  inhalant  can  be  obtained  from  the  producer  upon  payment  of  $1 
per  ounce.  Some  asthma  cures  are  sold  by  the  producer  only  after  preliminary 
correspondence  and  the  use  of  "  symptom  blanks,"  as  in  case  of  cancer  cures. 
Hayes'  Asthma  Cure  belongs  to  this  class. 

The  remedies  themselves  may  in  general  be  divided  into  three  classes:  Medi- 
cines intended  to  be  taken  internally,  medicines  intended  to  be  taken  by  inhala- 
tion, and  medicines  intended  to  be  burned  and  inhaled.  The  preparation  known  as 
Davis'  Liquid  Asthma  Remedy  is  an  interesting  example  of  remedies  belong- 
ing to  first  of  these  classes.  According  to  the  statement  which  appears  upon 
the  label,  the  product  contains  over  five  grains  of  chloral  hydrate  to  the  dose. 
The  directions  state  that  it  should  be  taken  "  one  tablespoonful  twenty  minutes 
after  meals,  at  bedtime,  and  on  arising  in  the  morning."  "Adults  can  repeat 
dose  every  two  hours."  "  Dose  can  be  increased  or  diminished,  or  taken 
oftener  if  needed."  The  statement  also  appears  that  it  "  keeps  you  from  having 
asthma."  The  danger  of  the  formation  of  the  chloral  habit  through  the  use 
of  such  a  preparation  is  apparent. 

Following  is  a  list  of  remedies  belonging  to  the  general  class  of  asthma  cure.s : 


Himalaya  Asthma  Cure. 

Hart's     Swedish    Asthma     and     Hay 

Fever  Cure. 
Haylene  Cure. 
Dr.  Olin's  Asthma  Cure. 
Dr.   R.   Schififmann's  German  Asthma 

Cure. 
Green  Mountain  Asthma  Cure. 
Papham  Asthma  Specific. 
Dr.  Olin's  Hay  Fever  Cure. 
Dr.  J.  R.  Stafford's  Olive  Tar. 
Himrod's  Asthma  Cure. 
Milk  Emulsion. 
Tucker's  Asthma  Specific. 
Brater's  Asthma  Cure. 
Dr.  B.  W.  Hair's  Asthma  Cure. 
Bryan's  Imperial  Asthma  Cure. 


Taft's  Asthma  Cure. 

Ballard's  Horehound  Syrup. 

Japanese  Oil. 

Severa's  Lung  Balsam. 

Davis'  Liquid  Asthma  Remedy. 

Davis'  Asthma  Powder. 

Warner's  Safe  Asthma  Cure. 

Asthma  Cure. 

Birch  Mountain  Tea. 

Chilean  Asthma  Cure. 

Frontier  Asthma  Cure. 

Hayes'  Asthma  Cure. 

Upham's  Asthma  Cure. 

Ascaco. 

Asthma  Cure.    Frank  Wetzel,  M.  D. 

William's  Asthma  Cure. 

Renacol. 


CATARRH  CURES. 


According  to  Doctor  Kebler : 

Nostrums  belonging  to  this  class  are  usually  intended  for  local  application 
to  the  nose  or  throat  and  are  generally  prepared  in  the  form  of  powder  (or 
"snuff"),  ointment  (or  'jelly'"),  or  in  stick  form  for  inhalation.  In  addition, 
there  are  liquids  intended  for  use  as  spray  or  douche.  When  the  "  cure  "  rises 
to  the  dignity  of  a  "  treatment,"  a  "  constitutional "  or  "  blood "  medicine  is 
usually  added,  as  in  case  of  "  Gauss'  Combined  Treatment,"  "  Dr.  T.  F.  Wil- 
liam's Treatment,"  etc.  The  catarrh  jellies,  catarrh  powders,  and  catarrh  cures 
generally  are  usually  sold  over  the  counter,  but  the  "  treatments"  are  furnished 
upon  application  to  the  advertiser  direct.  The  initial  advertisement  generally 
contains  an  offer  of  free  trial  treatment  or  a  free  book  upon  the  subject  of 
catarrh,  in  return  for  the  reader's  name  and  address.  Accompanying  the  book 
or  the  trial  treatment  are  numerous  testimonials  and  other  advertising  litera- 
ture intended  to  interest  the  correspondent  and  secure  a  sale  of  the  remedy.  It 
is  possible  that  some  of  these  preparations  do  good  in  chronic  nasal  catarrh 
in  a  palliative  way  through  a  cleansing  or  antiseptic  effort,  but  nont»  of  them 
can  possibly  make  good  the  extravagant  claims  made  for  them  with  regard  to 
the  cure  of  the  disease. 


REPOBTS   OF  THE  PKESIDENT  S  HOMES   COMMISSION. 


271 


A  list  of  preparations  belonging  to  tlie  general  class  of 
given  below: 


catarrh  cures"  is 


Bunsen's  Catarrh  Cure. 
Crown  Catarrh  Powder. 
Catarrh  Powder,  Britt,  Loeffler  &  Weil, 

New  York. 
Tousley's  Sneezeless  Snuff. 
Dr.  A.  W.  Chase's  Catarrh  Powder. 
Dr.  Olin's  Catarrh  Cure. 
Catarrh  Balm. 

Sanford's  Radical  Cure  for  Catarrh. 
Century  Catarrh  Cure. 
Pond's  Extract  Catarrh  Cure. 
I.  C.  R.    Instant  Catarrh  Relief. 
Ely's  Liquid  Cream  Balm. 
Dr.  Agnew's  Catarrh  Powder. 
Allan's  Catarrh  Cream. 
Biel's  Catarrh  Jelly. 
Dr.  Slack's  Mexican  Ointment 
Milk's  Catarrh  Cure. 
Kondon's  Catarrhal  Jelly. 
Cole's  Catarrh  Cure. 
Dr.  Birney's  Catarrhal  Powder. 
Thymo  Catarrh  Balm. 
Premuim  Prescription. 
Bear's  Catarrh  Remedy. 
Dr.  Bvory's  Diamond  Catarrh  Remedy. 
London  Catarrh  Cure.     London  Balm. 
Bering's    Vegetable    Specific    Catarrh 

Cure. 


Old  Saul's  Catarrh  Cure. 

Hall's  Catarrh  Cure. 

Gauss'  Combined  Catarrh  Cure. 

Century  Catarrh  Cure. 

Ozojell. 

Nosena. 

Pollantin  Powder  for  Catarrh. 

Paracamph. 

Dr.  Syke's  Sure  Cure  for  Catarrh. 

Ka-ton-ka. 

Branaman's  Catarrh  Cure. 

McCode  Catarrh  Cure. 

Sproule's  Catarrh  Cure. 

Botonic  Blood  Balm.     B.B.B. 

Mederine. 

Grove's  New  Discovery  for  Catarrh. 

Dr.  Shoop's  Catarrh  Remedy. 

Mucu-Tone. 

California  Mineral  Crystals. 

Hyomei. 

Davis'  Oil. 

Dr.  Blosser's  Catarrh  Cure. 

Catarrh  Cure.    Dr.  W.  O.  Coffee. 

Microcide. 

Dr.    W.    H.    Long's    Great    Mountain 

Moss  Catarrh  Jelly. 
Adlyne  Catarrh  Treatment. 
Blackburn's  Victory  Catarrh  Tablets. 


SKIN  CURES. 

Doctor  Kebler  divides  nostrums  advertised  for  this  purpose  into 
two  classes:  First,  those  which  are  claimed  to  cure  skin  diseases,  like 
eczema,  parasitic  skin  affections,  etc.;  and,  second,  the  products 
which  are  claimed  to  be  efficacious  in  the  prevention  and  cure  of  less 
serious  skin  affections,  such  as  erythema,  pimples,  and  blackheads. 
They  are  advertised  to  prevent  and  remove  wrinkles  from  the  faces 
of  persons  of  any  age;  to  impart  youthful  properties  to  the  skin, 
making  it  "  clear,  soft,  and  velvety ; "  and  to  remove  completely  and 
permanently  all  facial  blemishes,  pimples,  blackheads,  freckles,  tan, 
sunburn,  sallowness,  etc.  It  is  claimed  in  most  cases  that  they  ac- 
complish these  results  through  a  nourishing  effect  upon  the  skin, 
"  feeding  the  skin  through  and  through."  For  this  reason  they  are 
often  called  "  skin  foods."  They  are  analogous  to  "  nerve  foods," 
"  brain  foods,"  etc.  With  regard  to  this  use  of  the  word  "  food  "  in 
connection  with  the  names  of  medicinal  preparations,  it  may  be  w^ell 
to  recall  the  charge  to  the  jury  in  the  recent  case  of  the  United  States 
V.  K  N.  Harper  (see  p.  260). 


272 


REPORTS   OP   THE  PRESIDENT  S  HOMES  COMMISSION. 


Following  is  a  list  of  the  remedies  belonging  to  the  general  class 
of  skin  cures: 


Med-Aseptic  Cold  Cream  Skin  Food. 

Riker's  Violet  Cerate  Skin  Food. 

Hudnutine  Toilet  Cerate  (Skin  Food). 

Marvelous  Cold  Cream  Skin  Food. 

Excelsior  Skin  Food. 

Kingsbury's  Velvet  Skin  Food. 

De  Meridor  Granulus  Cold  Cream  Skin 

Food. 
Acme  Tablets.     Dermol. 
Cuticura   Soap. 
Cuticura  Ointment. 
Cuticura  Resolvent. 
W.  W.  W.  Wood's  Ointment. 
Pompeian   Massage    Cream    and    Skin 

Food. 
D.  D.  D.  Remedy  for  eczema,  etc. 
Sartoin  Skin  Food. 
Epp-O-Tone  Skin  Food. 
Cre-Mo-Jel. 

Wisdom's  Rubertim  (Skin  Food). 
Poslam. 
Palmer's  Vegetable  Cosmetic  Lotion. 


Zema-Cura. 

Dr.   Agnew's   Ointment. 

Perfect  C:k)ld  Cream  Skin  Food. 

Satin  Skin  Cream  and  Skin  Food. 

Red  Cross  Skin  Food. 

C.  C.  C.  Eczema  Cure. 

Dr.    Campbell's    Arsenic    Complexion 

Wafers. 
Crane's  Eczema   Cure. 
Para-camph. 

Rexall.     Cream  of  Almonds. 
Sempre  Giovine.     Skin  Food. 
Laird's  Bloom  of  Youth. 
Mme.  Hayden's  Skin  Food. 
Parisian  Electro  Skin  Food. 
Kintho   Beauty    Cream. 
Aughinbaugh's     Cold     Cream.       Skin 

Food. 
Eureka  Complexion  Tablets. 
Nadinola. 

Gourand's  Oriental  Cream. 
Lait  Antiphenique. 


RHEUMATISM  CURES. 

The  following  is  an  extract  from  Doctor  Kebler's  article  on  nos- 
trums and  fraudulent  methods  of  exploitation :  <» 

MAGIC   FOOT   DRAFTS. 

The  following  are  quotations  from  the  literature: 

"  Magic  Foot  Drafts  are  known  all  over  the  world  as  the  safest,  surest,  and 
simplest  cure  for  all  kinds  of  rheumatism.  They  cure  when  everything  else 
fails.  Best  of  all,  they  cure  to  stay  cured.  *  *  ♦  if  100,000  people  from 
every  State  and  Kingdom  of  the  earth  have  been  cured  of  rheumatism,  of  every 
kind  and  from  whatever  cause,  by  Magic  Foot  Drafts,  can  any  prejudice  exist 
in  your  mind  to  prevent  your  giving  the  remedy  a  fair  trial?" 

No  one  reading  these  quotations  can  arrive  at  any  other  conclusion  but  that 
"Magic  Foot  Drafts"  are  capable  of  curing  all  forms  of  rheumatism.  "Magic 
Foot  Drafts  "  consist  of  pieces  of  oil  cloth,  covered  on  the  unfinished  side  with 
a  border  of  adhesive  mixture,  and  the  central  portion  with  a  plaster  composed 
of  the  following; 

Per  cent. 

Poke   root 30 

Pine  tar 62 

Corn  meal 8 

These  drafts  are  to  be  applied  to  the  hollow  of  the  soles  of  the  feet  and  are 
claimed  to  effect  cures  in  the  following  manner : 

"  By  cutaneous  absorption  curative  elements  are  taken  from  the  draft.  These 
are  carried  to  the  blood  by  the  lymphatics,  and  neutralize  the  poisons.  ♦  ♦  * 
It  (Magic  Foot  Draft)  stimulates  the  nerves  to  activity.  The  nerves  in  turn 
act  on  the  muscles,  veins  and  arteries,  increasing  the  circulation  of  the  blood, 
compelling  it  to  hasten  and  deliver  up  its  poisons  from  the  whole  system  to 
the  sweat  glands  just  beneath  the  skin,  and  from  thence  it  Is  drawn  by  the  draft 
through  the  pores  and  absorbed.  Thus  is  effected  a  cure,  no  matter  where  the 
pain  Is  located,  because  all  the  blood  of  the  body  passed  through  the  capillarle«." 

There  Is  nothing  whatever  in  these  drafts  to  warrant  such  claims  and  rep- 
resentations. They  possess  no  curative  element  whatever  which  when  ab- 
sorbed into  the  blood  will  neutralize  the  poisons  which  are  supposed  to  be  the 
cause  of  the  rheumatism  and  in  this  manner  effect  a  cure. 


•Jouraal  Am.  Med.  Association,  Novbr.  10  and  17,  1906. 


KEPORTS   OF   THE  PRESIDENT  S  HOMES   COMMISSION". 


273 


A  particularly  interesting  feature  connected  with  this  scheme  is  that  the 
promoters  when  asked  for  reasons  for  their  claims  drew  on  the  writings  of  the 
best  authors  of  the  country,  such  as  the  late  J.  M.  Da  Costa,  Dr.  H.  C.  Wood, 
Dr.  J.  V.  Shoemaker,  Dr.  H.  A.  Hare,  the  medical  author  of  the  "American 
Dispensary,"  and  others.  These  authors,  when  informed  relative  to  the  use 
made  of  their  writings,  vigorously  protested,  claiming  that  any  interpretation 
of  their  writings  which  would  in  any  way  bolster  up  the  scheme  of  the  "  Magic 
Foot  Draft"  was  absolutely  unjustifiable. 

The  following  lists  have  been  supplied  by  Doctor  Kebler : 

BHEUMATISM    CURES. 


Kennedy's  East  Indian  Bitters. 

Nature's  Oil. 

Kelly's  Rheumatic  Syrup. 

Warner's   Safe   Rheumatism   Cure. 

T.  Rheumatic  Cure.  The  Great  Blood 
Purifier. 

Athlophorus. 

Griffith's  Compound  Mixture  of  Guaiac, 
etc. 

Dr.  Olin's  Rheumatic  Cure. 

Dr.  MacDonald's  Atlas  Compound. 
Specific  No.  18. 

Fulton's   Renal   Compound. 

Silodyne. 

R.  R.  R.    Radway's  Ready  Relief. 

Dr.   Shoop's  Rheumatic  Remedy. 

Wright's   Instant   Relief. 

Japanese   Oil. 

St.  Jacob's  Oil. 

Mysterious  Pain   Cure. 

Hamlin's  Wizard  Oil. 

Denver   Mud. 

Albert's  Remedy.  Cure  for  Rheuma- 
tism,  etc. 

Anchor  Pain  Dispeller.     Toxol. 

Rexall  Rheumatic  Cure. 


Dr.  Slack's  Mexican  Ointment. 

Dr.  McConkey's  Vigor  of  Life. 

Bogle's  Quaker  Balm. 

Celestial  Oil. 

Dr.  Radcliffe's  Great  Remedy  Seven 
Seals. 

Dr.  Kilmer's  W.  O.  Ointment. 

Fenner's  Kidney  and  Backache  Cure. 

Pnin  Balm. 

White's  Wonder  Worker  Herbs. 

A.  D.  S.  Rheumatism  Cure. 

Griswold's  X-ray  Pain  Killer. 

Dr.  Bell's  Anti  Pain. 

Schrage's  Rheumatic  Cure. 

Wood's  Rheumatic  Cure. 

Ka-Ton-Ka. 

Reagan's  Positive  Cure  for  Rheuma- 
tism and  Asthma. 

The  Wonderful  Wintergreen.  Great 
Rheumatic    Cure. 

Rheumetts.  Etts'  warranted  cure  for 
rheumatism. 

Bi-Lo-Zone. 

Yolta    Powder. 

Quinine  Whisky. 

Lane's  Rheumatic  Cure. 


KIDNEY  AND  BLADDER  CURES. 


Dr.  Gossom's  Kidney  and  Bladder 
Cure.  A  specific  for  Bright's  Dis- 
ease. 

Bick's  Laxative  Kidney  and  Liver  Tab- 
lets. Cures  Kidney  and  Liver  trou- 
bles in  all  its  forms. 

Bick's  Kidney  Pills. 

Brown's  Compound  Concentrated  Fluid 
Extract  of  Buchu. 

Zoeller's  Kidney  Remedy.  (Formerly 
Black  Gin.) 

National  Kidney  and   Liver  Cure. 

Jay  Neway's  Kidney  and  Liver  Rem- 
edy. 

McBurney's  Kidney,  Bladder  and 
Rheumatism  Cure. 

Welch's   Aegopodium. 

Mother  Gray's  Australian  Leaf. 

Dr.  Olin's  Kidney  Cure. 

O.  K.  Specific. 

Dr.  Maid's  Celebrated  Liver  and  Kid- 
ney Tablets. 

Dr.  Kilmer's  Swamp  Root. 

Dr.  Swan's  Celebrated  Liver  and  Kid- 
ney Cure. 

Chewalla. 

Dr.  Hobb's  Asparagus  Kidney  Pills. 

S.  Doc.  644,  60-2 iS 


Dr.  Bell's  Kidney  Pills. 

Warner's  Safe  Kidney  and  Liv<]       ire. 

/Vlma-Bromo. 

Warner's  Safe  Diabetes  Cure. 

Palmetto  Berry  Wine  with  Asparagus 
Wine. 

A  Texas  Wonder.  Hall's  Great  Dis- 
covery.    Removes  Gravel. 

Marsh  Root.     Kidney  and  Liver  Cure. 

Rexall  Kidney  Cure. 

Crane's  Kidney  and  Bachache  Cure. 

Begg's   Blood   Purifier. 

Allan's  Kidney  and  Liver  Cure. 

Dodd's  Kidney  Pills. 

Our  Own  Kidney  and  Liver  Cure.  Cer- 
tain Cure  of  Bright's  Disease. 

Kidneyetts.  Etts  warranted  cure  for 
kidneys  and  all  urinary  diseases. 

Bouvier's  Buchu  Gin  for  the  kidneys 
and  bladder. 

Dr.  Hubbard's  Kidney  and  Bladder 
Capsules. 

Doan's  Backache  Kidney  Pills. 

Var's  American  Kidney  Pills. 

Fitch's  Kidney  and  Liver  Cooler. 

Munyon's   Kidney   Cure. 


274 


KEPORTS   OF   THE  PRESIDENT  S  HOMES  COMMISSION. 


CANCER   CURES. 


The  following  is  Doctor  Kebler's  account  of  the  method  employed 
by  the  sure-cure  school  in  incurable  diseases.  Additional  informa- 
tion on  this  subject  will  be  found  in  "  Collier's  Weekly,"  July  14, 
1906: 

The  initial  step  in  the  sale  of  these  nostrums  is  usually  the  publication  in 
the  newspapers  of  an  advertisement  inviting  attention  to  a  certain  and  speedy- 
cure  for  cancer.  Following  is  an  illustration :  "  I  have  proven  cancer  can  be 
cured  at  home;  no  pain;  no  plaster;  no  knife.  I  have  discovered  a  new  and 
seemingly  unfailing  remedy  for  the  deadly  cancer.  I  have  made  most  aston- 
ishing cures.  I  believe  every  person  with  cancer  should  know  of  this  marvelous 
medicine  and  its  wonderful  cures,  and  I  will  be  glad  to  give  full  information 
free  to  all  who  write  me  and  tell  me  about  their  case."  Those  who  seek  further 
information  in  response  to  such  advertisements  receive  in  reply  a  stock  written 
letter,  shrewdly  devised  so  as  to  give  the  impression  that  the  communication 
is  a  personal  one.  Accompanying  this  is  a  "  symptom  blank,"  which  the  pros- 
pective purchaser  is  requested  to  fill  out,  and  printed  matter,  including  numer- 
ous testimonials,  all  setting  forth  the  claim  that  the  remedy  in  question  is  a 
certain,  speedy,  and  painless  cure  for  cancer.  If  there  is  delay  in  ordering  the 
remedy,  the  inquirer  becomes  the  recipient  of  letter  after  letter  in  which  the 
attempt  is  made  in  every  conceivable  way  to  cajole  him  into  purchasing  the 
"  cure."  The  cost  of  the  treatment  is  from  $15  to  $25  per  month,  some  con- 
cerns charging  more  than  others.  The  sufferer  is  therefore  obliged  at  the  out- 
set to  part  with  a  considerable  sum  of  money  before  he  receives  the  first  supply 
of  "  treatment."  The  result  is  invariably  keen  disappointment  on  the  part  of 
the  victim.  The  "  treatment "  consists  of  tonic  and  alterative  remedies  for 
internal  use  and  simple  applications  for  use  upon  the  skin.  They  are  indeed 
painless  in  most  cases  and  are  utterly  worthless  so  far  as  the  permanent  eradi- 
cation of  cancer  is  concerned.  Following  is  a  list  of  concerns  engaged  in  the 
sale  of  remedies  which  are  claimed  to  cure  cancer : 


Dr.  Bye,  Kansas  City,  Mo. 

Dr.  Curry  Cancer  Cure,  Lebanon,  Ohio. 

C.  Gee  Wo  Chinese  Medicine  Co.,  Port- 
land,  Oreg. 

Indian  Black  Vegetable  Salve  &  Reme- 
dies Co.,  Brooklyn,  N.  Y. 

Dr.  Johnson  Remedy  Co.,  Kansas  City, 
Mo. 

Dr.  L.  T.  Leach,  Indianapolis,  Ind. 


Mason  Cancer  Institute,  1700-8  Broad- 
way, New  York. 
Dr.  Mixer,  Hastings,  Mich. 

D.  Needham's  Sons,  Chicago,  111. 
Radio-Sulpho  Co.,  Denver,  Colo. 

E.  E.    Sonanstine,    M.    D.,    Colorado 
Springs,  Colo. 

Dr.  Rupert  Wells,  St.  Louis,  Mo. 

C.  Henry  Wilson,  M.  D.,  Brooklyn,  N.  Y. 


EPILEPSY  CURES. 


The  methods  employed  by  individuals,  institutes,  or  firms  who  prey 
upon  this  unfortunate  class  of  patients  are  manifold  and  can  best 
be  judged  by  an  extract  of  a  brief  submitted  by  Assistant  Attorney- 
General  Goodwin  to  the  Postmaster-General,  dated  July  23,  1908, 
and  which  is  as  follows : 

In  re  The  Epileptic  Institute  Company  and  the  Epileptic  Institute  and  their 
officers  and  agents  as  such  at  Cincinnati,  Ohio,  and  Dr.  H.  J.  Luecke  at  P.  O. 
Box  No.  99,  Cincinnati,  Ohio. 

On  June  6  last  this  concern  was  cited  to  show  cause  why  a  fraud  order  should 
not  be  issued  against  it.  ♦  ♦  *  The  facts  of  this  matter  as  I  find  them  to  be 
are  substantially  as  follows:  This  business  consists  of  a  medical  treatment  by 
mail  of  the  disease  of  epilepsy.  One  Otto  Kalmus,  a  resident  of  Cincinnati, 
commenced  the  business  in  the  spring  of  1903  under  the  name  of  Epileptic 
Institute,  and  so  continued  until  July,  1907,  when  he  incorporated  it  under  the 
name  of  "The  Epileptic  Institute  Company,"  he  continuing  as  president  and 
general  manager  and  principal  owner.  As  a  private  address  for  patients,  who, 
it  was  explained,  might  not  care  to  have  it  known  that  they  were  corresponding 
with  an  epileptic  institute,  use  has  been  made  of  the  name  of  Dr.  II.  J.  Luecke, 


REPORTS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  275 

a  physician  connected,  until  recently,  with  the  institute.  While  not  with  the 
institute  since  last  November,  Mr,  Pyle  and  Doctor  Schoenling  explained  at  the 
hearing  that  by  agreement  with  Doctor  Luecke  his  name  has  continued  to  be 
used  and  that  the  institute  receives  that  mail  addressed  to  him,  which  is  also 
directed  to  box  No.  99,  in  the  Cincinnati  post-office. 

Until  lately  communciation  with  epileptics  was  obtained  through  advertise- 
ments in  newspapers,  chiefly  those  circulated  among  Germans  and  other 
foreigners.     *     ♦     * 

More  recently  the  practice  has  obtained  of  purchasing  the  names  and 
addresses  of  epileptics  from,  as  the  inspector  says,  "  other  concerns "  that 
have  obtained  all  of  the  money  possible  from  such  unfortunates  without  effect- 
ing a  cure  and  then  mailing  circulars  to  such  persons,  urging  them  to  take 
treatment  from  the  institute.  *  *  *  The  samples  of  these  circulars  are 
among  the  papers.  They  are  filled  with  highly  colored  and  extravagant  rep- 
resentations with  reference  to  the  unprecedented  success  of  the  institute 
treatment,  which  it  denominates  the  "  Schonka "  treatment  as  a  cure  for 
epilepsy;  and  among  other  things,  it  is  represented  that  this  treatment  is 
original  with  the  institute  and  by  its  means  the  institute  can  successfully  treat 
the  heretofore  considered  incurable  disease  epilepsy,  and  in  many  cases  effect  a 
cure ;  that  the  treatment  is  something  not  known  to  medical  science  and  is  dif- 
ferent from  anything  used  by  the  profession  in  such  cases ;  that  the  physicians 
of  the  institute  are  skilled  and  experienced  specialists  and  include  "  one  of  the 
foremost  examining  specialists  in  America,  etc." 

The  time  that  this  institute  urges  its  patients  to  continue  the  treatment  is 
from  a  year  to  a  year  and  a  half,  and  longer,  varying,  of  course,  in  different 
cases.  Its  charge  for  medicine  ranges  from  about  $3  to  $9  a  month,  the  variance 
depending,  it  seems,  upon  the  amount  which  the  patient  can  be  induced  to  pay. 

Here  follow  10  pages  of  evidence.    The  report,  on  page  13,  states: 

The  medical  treatment  so  glowingly  advertised  by  this  institute  as  a  "  cure  " 
for  epilepsy  is  based  on  the  bromides.  It  is  what  in  general  is  known  as  the 
bromide  treatment.  Except,  and  this  is  where  the  institute  tests  its  claims  for 
unusual  and  peculiar  efiicacy,  that  the  drug  adonis  vernalis  is  used  in  conjunc- 
tion with  the  bromides.  In  connection  with  the  medical  treatment  the  usual 
and  ordinary  rules  regarding  diet,  hygiene,  etc.,  are  also  given.  Dr.  L.  F. 
Kebler,  Chief  of  Drug  Laboratory  Bureau  of  Chemistry,  United  States  Depart- 
ment of  Agriculture,  informed  the  Assistant  Attorney-General  "  that  what  is  in 
general  known  as  the  bromide  treatment  is  in  common  use  by  the  profession  in 
treating  epilepsy ;  that  its  physiological  action  has  been  quite  well  defined ;  that 
It  is  not  a  '  cure '  for  the  disease,  but  acts  simply  as  a  sedative,  and  in  this  way 
tends  to  suppress  the  attacks ;  that  medical  science  to-day  has  no  drug  treatment 
that  will  cure  this  disease;  that  the  disease  is  among  the  most  diflScult  and 
intractable  of  all  diseases  to  treat,  and  that  a  small  per  cent  of  the  more  favor- 
able cases  only  have  been  successfully  treated,  and  that  the  success  in  these 
instances  has  been  due  most  probably  to  the  condition  of  the  patient  himelf 
rather  than  to  the  medication."  Doctor  Kebler  has  also  drawn  my  attention  to 
the  following  recognized  medical  authorities,  who  speak  of  the  use  of  bromides 
in  treating  this  disease,  and  more  especially  of  evil  effects  that  may  follow  their 
long  continued  use. 

Here  follow  quotations  from  well-known  medical  authors,  strongly 
opposed  to  the  promiscuous  and  indiscriminate  use  of  the  bromides 
by  epileptics.  Of  these  the  opinion  of  Dr.  Wm.  T.  Sprattling,  an 
authority  on  this  disease  and  medical  superintendent  of  the  Craig 
Colony  for  Epileptics  at  Sonyea,  N.  Y.,  a  state  institution  of  recog- 
nized merit,  speaking  of  the  evils  that  may  attend  the  bromide  treat- 
ment, on  page  364,  says: 

If  pushed  too  far,  death  may  supervene  from  acute  bromide  poisoning.  This 
happened  in  the  case  of  a  boy  of  12  years  whom  I  knew,  whose  parents  gave 
him  too  frequent  doses  of  a  patent  nostrum,  the  essential  ingredient  of  which, 
as  with  the  bulk  of  patent  epileptic  cures,  was  bromide  of  potassium. 

All  of  the  other  citations  from  medical  authorities  are  of  similar 
import.  The  testimony  also  shows  that  in  the  opinion  of  such  emi- 
nent physicians  as  Drs.  J.  H.  Musser,  Eichard  C.  Cabot,  N.  S.  Davis, 


276  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

E.  L.  Hunt,  Charles  G.  Stocton,  Wm.  P.  Sprattling,  and  Chas.  S. 
Williamson,  it  is  impossible  to  make  a  reliable  diagnosis  of  epilepsy 
in  the  absence  of  the  patient  by  the  use  of  what  are  known  as 
''  symptom  blanks  "  sent  through  the  mails.  The  evidence  further 
shows  that,  in  the  opinion  of  these  physicians,  the  promiscuous  and 
indiscriminate  use  of  the  bromide  by  epileptics,  without  the  guidance 
of  a  physician  other  than  advice  sent  by  mail,  is  attended  by  danger 
to  the  patient.  As  to  the  merits  of  adonis  vernalis,  the  other  drug 
used  by  the  concern,  six  of  the  physicians  knew  of  no  instance  in 
which  the  cure  of  epilepsy  could  be  attributed  to  the  use  of  this  drug. 
Dr.  Wm.  P.  Sprattling's  answer  is  qualified  as  follows : 

No;  not  that  drug  alone.  The  proper  treatment  of  all  the  epilepsies — there 
are  many  kinds — can  only  be  carried  out  under  the  following  essential  heads: 
Medical,  general,  dietetic,  and  surgical.  Epilepsy  of  any  type  can  no  more  be 
properly  treated  by  the  use  of  drugs  alone  than  can  tuberculosis  be  treated  by 
drugs  alone.  A  combination  of  the  essentials  is  called  for  in  each  case — and  it 
is  the  scientific  application  of  these  that  alone  can  produce  the  best  results. 

The  evidence  discloses  the  fact  that  "  there  have  been  connected 
with  this  institute  since  it  commenced  business  in  the  spring  of  1903, 
three  physicians,  namely.  Dr.  E.  H.  Schoenling,  Dr.  H.  J.  Luecke, 
and  Dr.  A.  L.  Guertin.  Dr.  Schoenling  stated  at  the  hearing  that 
for  about  the  first  six  months,  being  half  owner  for  the  first  three 
months,  he  attended  to  the  medical  end  of  the  business  for  Mr.  Kal- 
mus,  examining  the  symptom  blanks  and  diagnosing  the  cases,  pre- 
scribing the  treatment,  and  compounding  it  as  well ;  that  after  he  left 
Doctor  Luecke  did  this  work  until  December,  1907;  and  that  since 
then  he  has  again  done  the  diagnosing  and  prescribing,  and  Doctor 
Guertin  has  done  the  compounding.  Doctor  Schoenling  graduated  in 
1900,  when  about  22  years  of  age,  has  made  no  special  study  of  epi- 
lepsy except  in  connection  with  this  mail-order  business,  is  not  a  mem- 
ber of  any  medical  society,  is  not  regarded  in  the  profession  as  a 
specialist,  and  has  most  of  the  time  since  his  graduation  worked  for 
$25  a  week  for  a  Dr.  Charles  Shafer,  of  Cincinnati,  who  advertises  in 
the  public  prints,  soliciting  kidney  and  urinary  and  sexual  cases.  The 
salary  paid  him  for  his  work  at  the  institute,  he  says,  has  been  less 
than  $100  a  month ;  he  stated  that  he  spent  but  a  few  hours  each  day 
at  the  institute  and  regarded  it  as  a  sort  of  side  line  to  his  regular 
work  with  Doctor  Shafer. 

Doctor  Luecke  graduated  in  1901,  went  to  this  institute  in  1903,  has 
had  no  special  preparation  in  epilepsy,  does  not  consider  himself  a 
specialist,  and  was  paid  by  the  institute,  the  inspector  says,  only  $15 
a  month.  He  is  not  a  member  of  any  medical  society,  his  professional 
standing  is  doubtful,  his  regular  practice  is  sexual  and  urinary  dis- 
eases, and  in  December  last  his  advertisements  were  excluded  from 
the  Cincinnati  papers  on  the  ground  that  they  related  to  the  sale  of 
abortifacients  and  the  performing  of  criminal  operations  in  violation 
of  the  statutes  of  the  United  States.  Doctor  Guertin  receives  $35  a 
month  from  the  institute  for  his  services,  works  there  but  a  few  hours 
each  day,  is  not  a  member  of  any  medical  society,  his  standing  in  the 
profession  is  questionable,  he  has  little  or  no  practice  in  Cincinnati, 
and  was  investigated  by  this  department  in  1905  for  giving  a  concern 
against  which  was  pending  a  charge  of  fraud  under  these  statutes, 
and  against  which  a  fraud  order  was  later  issued,  a  testimonial  as  to 
its  medicine,  which  he  later  admitted  to  the  department  was  done  for 


REPORTS   OF    THE   PRESIDENT'S   HOMES   COMMISSION.  277 

a  valuable  consideration  and  without  reading  the  statement  which  he 
was  paid  to  sign,  and  which  he  repudiated  as  untrue.  He  admits  he 
is  not  a  specialist. 

Those  are  the  self-styled  specialists,  and  "  foremost  examining 
specialists  of  America  "  of  this  institute.  No  comment  is  needed  on 
these  facts  to  show  the  utter  falsity  and  fraudulency  of  the  represen- 
tations in  question." 

The  brief,  which  covers  32  pages,  also  discloses  the  fact  that  this 
institute  has  treated  in  all  about  6,000  persons,  and  concludes  as 
follows : 

The  physicians  of  the  institute  were  not  specialists  as  pretended,  nor  did  the 
staff  of  the  institute  include  the  foremost  examining  specialises  of  America,  but 
in  truth  the  physicians  of  the  institute  were  young  graduates  and  men  without 
standing  in  their  profession  and  following  questionable  lines  of  practice,  and 
were  men  employed  at  what  would  seem  to  be  about  as  small  salaries  as  any 
at  which  the  required  service  could  be  obtained;  and  the  treatment  intended 
to  be  adniinistered  was  not  entirely  harmless,  but  was  of  a  nature  that  might 
wreck  the  health  and  even  reason  and  life  themselves  of  the  patient.  There- 
fore, while,  in  what  may  be  said  to  be  a  comparatively  few  instances — as  the 
institute  has  not  disclosed  its  re(?ords  in  the  great  number  of  its  cases — patients 
have  experienced  from  the  treatment  what  is  the  ordinary  effect  of  the  bromides 
and  may  feel  satisfied  with  so  much,  yet  I  feel  it  is  not  true  that  the  other  and 
the  greater  share  of  the  patrons  of  the  institute  have  not  been  deliberately 
deluded  with  false  hopes  and  representations,  and  defrauded  of  the  money 
which  they  probably  would  not  have  paid  if  aware  of  the  facts,  in  addition  to 
having  their  health,  reason,  and  life  endangered. 

The  answer  to  the  claim  that  certain  of  the  patrons  are  satisfied  with  what 
benefit  they  do  get  from  the  treatment,  is  that  in  that  event,  were  the  business 
conducted  with  an  honest  purpose,  there  should  be  no  occasion  for  promising 
any  more. 

The  satisfaction  of  the  few  is  not  justification  for  the  defrauding  of  the  many. 
Furthermore,  this  scarcely  is  a  case  in  which  the  patients  are  sufficiently 
familiar  with  the  facts  to  be  able  to  determine  whether  they  should  be  satisfied 
or  not,  and  this  is  especially  so  of  the  patient  who  has  commenced  the  treatment 
but  comparatively  recently,  and  particularly  among  the  class  of  people  among 
whom  it  appears  the  most  of  the  business  of  the  institute  is  solicited. 

I  find  that  the  business  conducted  by  Otto  Kalmus  under  the  name  of  the 
Epileptic  Institute  and  the  Epileptic  Institute  Company  at  Cincinnati,  Ohio, 
referred  to  above,  is  a  scheme  for  obtaining  money  through  the  mails  by  means 
of  false  and  fraudulent  pretenses,  representations,  and  promises,  and  I  therefore 
recommend  the  issue  of  a  fraud  order.  The  United  States  attorney  at  Cincin- 
nati has  caused  criminal  proceedings  to  be  instituted  against  Mr.  Kalmus  for 
having  devised  and  used  the  mails  in  the  operation  of  a  scheme  to  defraud  in 
violation  of  section  5084,  Revised  Statutes,  in  connection  with  this  Epileptic 
Institute  business. 

A  fraud  order  was  issued  July  23,  1908. 

THE   MIRACLE   WORKERS. 

Mr.  Samuel  Hopkins  Adams,  in  Collier's  Weekly,  August  4,  1906, 
gives  an  excellent  account  of  several  magnetic  quacks,  radio-quackery, 
etc.  The  following  memorandum  is  copied  from  the  records  of  the 
Assistant  Attorney- General's  Office  in  the  case  of  Prof.  T.  A.  Mann, 
Institute  of  Radiopathy  and  Central  School  of  Psychology,  and 
their  officers  and  agents  as  such  at  Rochester,  N.  Y.  The  Postmaster- 
General,  April  29,  1908,  issued  an  order  forbidding  the  delivery 
of  mail  matter  and  money  orders  to  this  concern.  *  *  *  ''In 
these  advertisements  he  endeavors  by  the  use  of  misleading  and  ex- 
travagant assertions  to  lead  the  reader  to  believe  that  he  is  a  doctor 
of  eminence  in  the  United  States,  that  he  has  discovered  a  wonderful 


278  EEPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

force  of  nature  possessing  marvelous  curative  properties,  that  by 
means  of  this  power  he  is  able  to  and  will  cure  diseases  which  are 
generally  considered  hopeless.  Among  the  representations  calculated 
to  produce  this  belief  are  those  to  the  effect  that  '  with  his  phenom- 
enal poAver  this  man  works  wonders,  the  blind  see,  the  paralyzed 
walk  *  *  *  there  is  no  illness  which  he  can  not  cure ; '  he  gives 
back  health  in  a  most  incomprehensible  manner  to  sick  people  who 
have  been  declared  by  physicians  to  be  incurable;  that  he  can  and 
will  cure  blindness,  deafness,  consumption,  paralysis,  cancer,  etc.; 
that  he  has  found  the  most  marvelous  power  man  has  so  far  invented. 
*  *  *  His  advertisements  extended  to  the  foreign  press  and  com- 
plaints are  in  the  case  from  the  Italian  consular  agent  at  New  York, 
from  a  member  of  the  Berlin  Press  Association,  from  Mr.  Louis 
Michel,  a  prominent  American  residing  in  Germany,  and  from  sev- 
eral other  persons,  to  the  effect  that  Mann  is  swindling  thousands  of 
poor  persons  in  Italy,  Germany,  France,  Spain,  South  America, 
Central  America,  Mexico,  and  Cuba.  One  of  the  pamphlets  issued 
by  him  states  that '  we  thoroughly  explain  to  you  how  to  renew  youth 
and  how  to  keep  it ;  how  to  acquire  force  and  how  to  use  it  to  conquer 
environment.' "  ' 

OTHER  FORMS  OF  QUACKERY. 
TOPICAL    REMEDIES.^* 

Among  these  may  be  mentioned  the  fraudulent  and  misleading 
advertisements  in  connection  with  many  of  the  hair  restoratives, 
tonics,  hair  dyes,  and  a  number  of  cosmetic  preparations  especially 
intended  for  colored  people,  like  "Glossine,"  "Anti-Kinkine,"  "  Kink- 
ine,"  "Straightine,"  "Ozonized  Ox  Marrow,"  for  which  it  is  claimed 
that  they  will  make  kinky,  knotty,  and  curly  hair  straight.  The  hair 
restorers  are  credited  with  the  property  of  producing  a  luxuriant 
growth  of  hair,  "  make  the  hair  grow  out  on  bald  spots,"  "  turn  gray 
hair  dark,"  etc. 

Medical  literature  contains  a  number  of  instances  in  which  symp- 
toms of  lead  poisoning  and  cases  of  paralysis  were  traced  to  the 
habitual  use  of  cosmetics,  hair  dyes,  and  hair  restorers.  In  the 
Pharmacal  Journal  (Vol.  LXXIV,  p.  223)  will  be  found  a  list 
of  hair  restorers.  In  12  articles  analyzed  the  percentage  of  lead 
varied  from  0.3  to  2.32.  Other  drugs  in  such  preparations  have  been 
known  to  produce  violent  inflammation  of  the  scalp. 

In  this  category  also  come  some  of  the  skin  tonics,  face  lotions,  and 
toilet  preparations.  One  of  the  9  analyzed  contained  47  grains  of 
corrosive  sublimate  and  this  same  poison  was  contained  in  varying 
proportions  of  1  to  15  grains  per  ounce  in  all;  and  yet  it  is  claimed 
that  they  are  "  perfectly  harmless  for  the  removal  of  freckles,"  "  to 
make  pretty  faces,  etc."  In  discussing  the  subject  of  skin  bleaches 
and  beautifiers,  Doctor  Kebler  says  that  one  of  the  agents  used  for 
improving  the  complexion  was  found  on  analysis  to  consist  largely 
of  Rochelle  salts.  Another  product  sold  under  the  designation  of 
"  complexion  tablets  "  contained,  among  other  ingredients,  strychnin, 
and  he  relates  an  instance  where  a  child  2|  years  old  accidentally 
consumed  a  number  of  these  tablets  and  died  from  strychnin  poison- 

o  See  Doctor  Kebler's  interesting  article  on  nostrums  and  fraudulent  methods 
of  exploitation,  Jour.  Am.  Med.  Assoc,  Nov.  10-17,  1906. 


BEPORTS    OF    THE   PRESIDENT'S   HOMES   COMMISSION.  279 

ing.  In  this  connection  he  also  exposes  the  fraudulent  claims  of  the 
Mexican  Remedy  Company  for  its  "Aquamiel,"  "  a  magical  bust  de- 
veloper and  the  most  marvelous  bust  producing,  blood  enriching, 
tissue  forming  preparation — a  product  of  the  famous  mague  plant 
of  Mexico."  Analysis  showed  that  the  medicine  is  absolutely  worth- 
less as  a  tissue  developer,  etc.  In  like  manner  he  disposes  of  the 
numerous  plasters  advertised  as  "  positive  cures  for  consumption  and 
other  ailments,"  "  the  American  Herb  cure,"  and  "  Force  of  Life 
remedies,"  "  Nutriola,"  etc. 

PRESCRIPTION    NOSTRUMS." 

Since  the  passage  of  the  food  and  drugs  act,  which  forbids  the  use 
of  any  statement,  design,  or  device  which  is  false  or  misleading  on 
the  label  or  package  of  any  drug  product,  etc.,  the  manufacturers  of 
nostrums  found  themselves  seriously  handicapped.  But  as  in  all 
diabolical  pursuits,  a  way  appears  to  have  been  found  to  circumvent 
the  provisions  of  the  law.  Doctor  Kebler  informs  us  that  as  long 
as  the  law  does  not  forbid  the  publication  of  misrepresentations  and 
fraudulent  statements  in  newspapers,  this  opening  is  taken  advantage 
of  by  many  promoters  of  medicinal  agents.  A  rather  common 
method  is  the  jmblication  in  the  newspapers  of  advertisements  ex- 
tolling the  virtue  of  certain  remedies  in  certain  diseases.  Often  the 
receipt  is  published  in  connection  with  the  advertisement  or  fur- 
nished upon  application  free  of  charge.  The  prescription,  however, 
always  contains  at  least  one  product  bearing  a  unique  coined  name, 
the  nature  and  composition  of  which  is  known  only  by  the  advertiser, 
or  the  parties  interested  in  furnishing  the  sale  of  the  remedy.  As  a 
result  the  local  druggist  is  either  unable  to  compound  the  prescrip- 
tion, or  in  doing  so  he  is  compelled  to  obtain  it  from  the  parties  in 
question,  or  the  patient  is  compelled  to  have  the  prescription  filled 
by  the  advertiser  at  an  exhorbitant  price.  Doctor  Kebler  states  that 
this  is  really  an  old  scheme,  which  was  exposed  in  the  "  Druggists' 
Circular,"  page  3,  1859,  in  connection  with  the  consumption  cure  of 
a  fictitious  Rev.  Edward  A.  Wilson,  and  a  questionable  "  Extract 
Blodgetti."  The  individual  behind  this  scheme  during  recent  years 
was  a  Mr.  C.  A.  Abbott,  who  himself  has  no  medical  knowledge 
whatever,  and  it  appeared  in  the  recent  investigation  by  the  Post- 
Office  Department  that  wdth  regard  to  the  Wilson  Remedy,  no  such 
ingredient  as  extract  blodgetti  was  used.  This  name  was  used  in  the 
prescription  solely  for  the  purpose  of  making  it  impossible  for  the 
average  druggist  to  iill,  thereby  compelling  the  patient  to  send  the 
advertiser  $3  for  the  treatment,  although  he  has  no  intention  of  in- 
cluding extract  of  blodgetti  in  the  compound  furnished  by  him  on 
such  orders.  The  Postmaster- General  promptly  issued  a  fraud  order 
March  20,  1908. 

Doctor  Kebler  calls  attention  to  the  "Arabian  Sea  Grass  "  prescrip- 
tion in  connection  with  "  Le  Grande  Arabian  Recipe,"  exploited  by 
a  Dr.  J.  A.  Lawrence,  of  Brooklyn,  N.  Y.,  "  for  the  cure  of  catarrh, 

«» Condensation  of  the  subject-matter  contained  in  a  special  paper  prepared  for 
the  Commission  by  Dr.  Lyman  F.  Kebler,  Division  of  Drugs,  U.  S.  Dept.  of 
Agriculture. 


280  BEPORTS  OF   THE  PRESIDENT'S   HOMES  COMMISSION. 

bronchitis,  hay  fever,  and  all  diseases  of  the  mucous  membrane,"  and 
of  which  the  "  Druggists'  Circular  "  in  1885  said : 

It  thus  appears  that  9  out  of  the  16  substances  either  do  not  exist  or  are  not 
articles  of  commerce.  The  trap  is  so  evident  that  no  druggist  need  fail  to 
see  it,  but  we  have  no  doubt  that  many  persons  are  influenced  to  send  the 
"  Doctor  "  $3  for  the  medicines. 

Doctor  Kebler  writes  of  a  similar  scheme  under  the  designation  of 
"  Dr.  Stevens'  East  India  Consumption  Cure,"  and  gives  the  follow- 
ing sample  of  the  advertisement  used  in  newspapers : 

Consumption.  An  old  physician,  retired  from  business,  had  placed  in  his 
hands  by  an  East  India  missionary  the  formula  of  a  simple  vegetable  remedy  for 
the  speedy  and  permanent  relief  of  consumption,  bronchitis,  catarrh,  asthma, 
and  all  throat  and  lung  affections;  also  a  positive  and  radical  cure  for  nervous 
debility  and  all  nervous  complaints.  Having  tested  its  wonderful  curative 
powers  in  thousands  of  cases,  and  desiring  to  relieve  human  suffering,  I  will 
send  free  of  charge  to  all  who  wish  it  this  recipe,  with  full  directions  for  pre- 
paring and  using.  Sent  by  mail,  by  addressing,  with  stamp,  naming  this  paper, 
W.  A.  Noyes,  847  Powers  Block,  Rochester,  N.  Y. 

As  in  the  case  of  the  Wilson  remedy,  the  patient,  upon  replying  to 
the  advertisement,  received  printed  matter  setting  forth  a  prescrip- 
tion, testimonials,  and  a  story  telling  how  "  Dr.  Stevens,"  who  in 
1886,  was  afflicted  with  consumption,  was  cured  through  the  agency 
of  the  "  Sativa  remedy,"  which  he  received  from  the  hands  of  an  aged 
missionary  who  had  spent  many  years  in  India  and  other  countries 
of  the  East,  and  who  had  given  the  recipe  to  his  successor,  W.  A. 
Noyes,  the  present  owner  of  the  business,  with  the  admonition  to 
carry  on  the  work  of  making  the  remedy  known  to  the  afflicted  as 
long  as  was  possible. 

The  prescription  contained  10  ingredients,  among  them  2  unknown 
substances.  Investigation  by  the  Post-Office  Department  developed 
the  fact  that  there  was  not,  at  the  time  of  the  investigation  nor  had 
there  ever  been  a  Doctor  Stevens  or  a  missionary  connected  with  the 
scheme,  and  a  fraud  order  was  promptly  issued. 

It  will  be  readily  understood  that  such  schemes  can  not  be  carried 
on  for  any  length  of  time  without  attracting  the  attention  of  the 
officials  of  the  Post-Office  Department  or  of  the  Bureau  of  Chemistry. 
The  scheme  finally  evolved,  according  to  Dr.  Kebler,  is  "  that  the 
false  and  misleading  representations,  statements,  and  promises  should 
appear  in  newspapers  in  the  form  of  '  reading  advertisements.' " 
The  advertisement  usually  contained  a  prescription,  the  filling  of 
which  required  several  well-known  efficacious  agents,  together  with 
a  "  fancy  name  "  product.  The  prospective  patient  was  advised  that 
the  prescription  could  be  filled  by  any  druggist.  The  druggist, 
therefore,  is  made  a  party  to  the  scheme.  In  order  to  render  the 
scheme  more  effective,  it  w;is  found  desirable  to  place  the  advertise- 
ment in  papers  in  such  a  manner  as  to  make  them  appear  either  as 
editorials  or  general  reading  matter.  As  can  readily  be  seen,  this 
required  the  acquiescence  and  cooperation  of  those  interested  in  the 
management  of  newspapers.  On  inquiry  it  was  found  that  news- 
paper managers  require  an  increased  rate  in  placing  these  advertise- 
ments, double  the  regular  price  being  the  customary  charge.  From 
the  large  amount  of  advertising  and  the  number  of  these  remedies, 
this  scheme  has  apparently  been  very  attractive,  not  only  to  the  news- 
papers, but  to  the  promoters  of  these  remedies  as  well.    The  earlier 


REPORTS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  281 

mail-order  remedies  were  intended  for  the  ignorant  classes,  but  the 
modernized  scheme  is  for  the  benefit  of  the  better  educated,  and  that 
it  does  appeal  to  this  class  is  shown  by  the  fact  that  requests  for  in- 
formation concerning  the  same  come  from  lawyers.  Congressmen, 
doctors,  etc. 
The  following  is  a  copy  of  one  of  the  advertisements: 

AN   editor's   advice   TO  KHEUMATICS. 

It  is  truly  said  that  the  "  Lord  tempers  the  wind  to  the  shorn  lamb,"  and 
He  also  seems  to  send  for  every  ill  a  remedy.  Modern  science  has  done  much 
to  develop  these  remedies,  yet  sufferers  from  rheumatism  occasionally  find  it 
hard  to  believe  that  there  exists  any  positive  relief  for  their  distress.  Never- 
theless, we  are  in  a  position  to  recommend  to  our  readers  who  suffer  from 
rheumatism  or  kidney  or  bladder  trouble  or  any  derangement  of  the  urinary 
or^^ans  an  unfailing  relief  for  their  pains.  This,  we  know,  will  be  all  the  more 
welcome  news  because  the  remedy  is  easily  produced. 

Go  ask  your  druggist  for  one-half  ounce  fluid  extract  cascara  aromatic,  1 

ounce  of  concentrated  compound,  and  4  ounces  of  aromatic  elixir.     The 

compound  is  put  up  only  in  1-ounce  bottles,  so  be  sure  you  get  the  right 

article.  Take  these  three  things  home,  put  them  in  a  bottle,  mix  them,  and 
take  1  teaspoonful  after  each  meal  and  at  bed  time.  For  children,  from  one- 
third  to  one-fourth  of  this  dose  will  be  enough.  In  order  to  make  a  permanent 
cure  doubly  certain  it  is  best  to  continue  taking  the  remedy  for  several  days 
after  all  pain  and  swelling  have  disappeared.  You  will  then  be  as  free  from 
pain  as  if  you  had  never  known  what  rheumatism  was. 

Investigation  by  Doctor  Kebler  shows  that  "  since  the  passage  of 
the  federal  law  about  40  of  these  prescription  nostrums  have  been 
launched.  *  *  *  The  price  charged  is  exorbitant  to  a  degree. 
*  *  *  This  is  admitted  even  by  the  promoters,  but  the  contention 
is  that  it  is  necessary  to  charge  a  high  price  because  of  the  extensive 
and  expensive  advertising  necessary  to  bring  the  remedies  to  the  atten- 
tion of  the  public.  The  men  back  of  these  schemes  are  usually  nt)w, 
or  have  been,  connected  with  some  advertising  agency  or  have  acted 
in  the  capacity  of  advertising  agent  of  some  newspaper.  They  have 
no  knowledge  of  medicines  and  claim  none  is  needed,  because  the 
large  pharmaceutical  manufacturers  are  prepared  not  only  to  supply 
the  medicine  but  the  medical  data  as  well.  The  afflictions  usually 
aimed  at  for  treatment  by  these  remedies  are  those  affecting  the  lungs, 
stomach,  liver,  kidneys,  and  heart." 

ErnCIENT  WORK  OF  THE  POST-OFFICE  DEPARTMENT  AND  OF  THE  DEPART- 
MENT OF  AGRICULTURE  IN  ENFORCING  THE  LAW  AROUSES  OPPOSITION. 

Sufficient  evidence  has  been  presented  to  indicate  that  the  executive 
departments  of  the  Government  are  determined  to  administer  the  law 
upon  the  principle  that  "  Righteousness  exalteth  a  nation."  It  was 
to  be  expected  that  the  promoters  of  fraudulent  transactions  would 
leave  no  stone  unturned  to  accomplish  their  purpose.  In  the  lan- 
guage of  "  Collier's  Weekly,"  June  23,  1906 : 

There  was  an  ominous  presumption  of  foreknowledge  in  what  Attorney  Lan- 
nen,  representing  the  National  Food  Manufacturers'  Association  in  its  fight  for 
adulterated  foods,  said  at  the  pure  food  hearing :  "  I  say  that  it  will  be  but  a 
short  time  (sic)  before  the  Post-Office  Department  will  be  made  to  conform  to 
better  rules  in  promoting  justice." 

On  March  12,  1906,  a  bill  was  introduced  by  Mr.  Crumpacker  in 
the  House  of  Representatives  to  provide  for  a  judicial  review  of 


282  REPORTS   OF   THE   PRESIDENT'S   HOMES   COMMISSION. 

orders  excluding  persons  from  the  use  of  United  States  mail  facili- 
ties." The  effect  of  this  legislation,  in  the  judgment  of  the  Post- 
Office  Department,  would  be  to  paralyze  the  good  work  by  the  Gov- 
ernment in  suppressing  "  fake  get-rich  schemes,"  "  quack  medicinal 
cure-alls,"  and  an  inconceivable  variety  of  confidence  games  per- 
petuated through  false  and  misleading  advertisements,  such  as  have 
in  the  past  cost  the  public  millions  of  dollars. 

According  to  the  report  of  the  Postmaster-General  "  over  2.400 
fraud  orders  have  been  issued  by  the  Post- Office  Department  under 
authority  of  the  act  of  1890  and  the  supplemental  act  of  1895.  In 
less  than  30  of  these  cases  has  the  propriety  of  the  order  been  chal- 
lenged in  court,  and  in  none  of  them  has  it  been  held  erroneous  or 
unwarranted.  This  record  is  of  exceeding  significance,  and  shows 
clearly  that  the  administration  of  these  statutes  by  the  Post-OfRce 
Department  has  been  marked  by  the  utmost  care  and  conservatism. 
The  period  of  time  extends  over  the  administration  of  many  different 
Postmasters-General  of  varying  political  parties,  and  the  same  thor- 
oughness and  judicial  caution  have  characterized  the  administration 
of  the  statutes  by  all  of  these  officers.  This  record  is  strong  assur- 
ance that  their  future  enforcement  will  be  marked  by  full  regard  for 
the  rights  and  privileges  of  all  citizens." 

The  following  are  extracts  from  the  statement  of  the  case  by  the 
People's  Lobby: 

FRAUD  ORDERS  NOW  REVIEWED  BY  THE  COURTS. 

From  this  excerpt  it  is  clear  that  the  courts  do  now  review  the  action  of  the 
Postmaster-General  in  issuing  orders.  In  order  to  relieve  the  department  of 
unjust  criticism,  however,  the  Postmaster-General  is  not  opposed  to  an  express 
provision  of  the  law  for  a  review  in  the  manner  provided  by  the  bill  prepared 
by  Representative  Foster,  a  member  of  the  Judiciary  Committee,  which  meas- 
ure was  passed  over  in  favor  of  the  Crumpacker  bill. 

Although  the  measure  is  of  such  vital  importance,  it  was  never  submitted  to 
the  Postmaster-General  for  his  opinion,  nor  was  he  asked  to  appear  before  the 
Judiciary  Committee  of  the  House.  The  Assistant  Attorney- General  for  the 
Post-Office  Department  appeared  of  his  own  volition  and  argued  against  the 
bill.     *     *     * 

It  is  positively  asserted  by  the  Post-Office  Department  that  the  influences 
behind  the  Crumpacker  bill  are  B.  G.  Lewis,  of  St.  Louis,  Mo.,  "  Prof."  Thomas 
F.  Adkin,  of  Rochester,  N.  Y.,  and  the  "Hon."  E.  F.  Hanson,  of  Chicago,  111. 
Lewis  was  the  promoter  of  the  People's  United  States  Bank,  which  was  organ- 
ized to  transact  all  its  business  through  the  mails.  A  fraud  order  was  issued 
against  the  People's  Bank,  July  6,  1905,  because  of  the  alleged  false  and 
fraudulent  representations  which  the  Postmaster-General  declared  Lewis  made 
in  the  promotion  of  his  scheme.  Of  these  one  of  the  most  important  was  the 
promise  that  no  loan  of  funds  should  be  made  to  the  president  or  to  any  of  the 
directors  of  the  bank.  Up  to  the  time  of  the  issuance  of  the  fraud  order  loans 
had  been  made  to  Lewis  and  to  certain  of  his  business  enterprises  aggregating 
$907,538.83  upon  insufficient  security  or  no  security  at  all. 

The  action  of  the  Postmaster-General  in  issuing  a  fraud  order  against  the 
People's  Bank  was  reviewed  by  the  United  States  circuit  court  of  appeals,  and 
the  Postmaster-General  was  fully  sustained. 

Adkin  was  the  head  of  the  so-called  "  New  York  Institute  of  Physicians  and 
Surgeons,"  of  Rochester,  N.  Y.,  which,  in  advertising  a  treatment  for  disease 
denominated  "  vitaopathy,"  made  such  extravagant  claims  as  in  the  following 
advertisement : 

"  Dead  man  talked  back  to  life.  Miraculous  rescue  from  grave.  Medical 
science  completely  upset  by  Rochester  wonder-worker,  who  restores  life  and 
heals  the  sick  without  the  use  of  drastic  drugs  or  the  surgeon's  knife;  hope- 
less invalids  restored  to  health. 


KEPORTS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  283 

"  I  feel  that  it  is  my  duty  as  a  Christian  to  use  this  wonderful  power  that 
has  been  given  to  me  for  the  benefit  of  all  mankind  to  cast  out  from  their 
body  the  evils  of  disease.  I  have  cured  them  that  quiclily  that  I  have  been 
credited  with  working  miracles." 

Adkin  and  the  "  New  York  Institute  of  Physicians  and  Surgeons  "  were  de- 
nied the  use  of  the  mails,  and  the  action  of  the  Post-Office  Department  was 
sustained  by  the  supreme  court  of  the  District  of  Columbia. 

Hanson  organized  the  "  Nutriola  Company  "  at  Belfast,  Me.,  and  subsequently 
moved  his  patent  medicine  business  to  Chicago,  111.  A  fraud  order  was  issued 
against  this  concern.  Furthermore,  Hanson  was  indicted  and  convicted  on  the 
charge  of  misusing  the  mails  because  some  of  his  literature  was  improper  and 
obscene.     *     *     * 

The  Congressional  Record  bears  out  the  charge  that  the  Crumpacker  Bill 
was  railroaded  through  the  House.  Three  days  before  the  holiday  recess 
the  sponsor  oi  this  measure  secured  the  passage  of  a  resolution  placing  it  on 
the  calendar  as  a  privileged  bill.  It  is  of  particular  importance  to  note  that 
Mr.  Crumpacker  put  through  his  resolution  largely  on  this  statement : 

"  I  submitted  the  bill  to  Mr.  Overstreet,  the  chairman  of  the  Committee  on 
the  Post-Office  and  Post-Roads  *  *  *  and  he  said  the  bill  ought  to  be 
passed.  He  has  had  experience  enough  to  believe  the  bill  ought  to  pass,  and 
all  I  am  asking  now  is  to  give  the  bill  a  status  on  the  calendar  so  as  it  can 
be  taken  up  on  its  merits." 

Mr.  Overstreet  was  absent  when  this  statement  was  made.  As  a  matter 
of  fact,  the  chairman  of  the  Committee  on  the  Post-Office  and  Post-Roads  made 
the  strongest  speech  in  opposition  to  the  bill  when  it  came  up  for  final  action 
January  7,  1907,  and  objected  privately  to  Mr.  Crumpacker  that  morning  on 
the  inadequate  time  to  be  allowed  for  the  consideration  and  discussion  of  so 
vital  a  measure.  Representative  Mann,  of  Illinois,  also  opposed  the  bill  in  a 
vigorous  manner. 

The  Crumpacker  Bill  is  now  in  the  Judiciary  Committee  of  the  Senate, 
where  it  is  hoped  more  consideration  will  be  given  to  the  protection  of  the 
public  and  less  weight  attached  to  the  interests  of  borrower  Lewis,  the  "  Hon." 
E.  F.  Hanson,  and  "  Professor  "  Adkin. 

It  is  gratifying  to  note  that  the  bill  was  held  up  by  the  Senate  Judiciary 
Committee  for  a  careful  consideration. 

CONCLUSIONS  AND  RECOMMENDATIONS. 

A  review  of  the  evidence  in  the  foregoing  pages  reveals  the  fact  that 
existing  laws  are  insufficient  to  cope  with  the  evil.  The  enactment 
of  Mr.  Mann's  bill,  House  resolution,  and  other  amendments  to  the 
poison  law.  while  steps  in  the  right  direction,  will  not  prevent  im- 
proper traffic  in  the  habit-forming  drugs  so  long  as  we  have  to  deal 
with  unscrupulous  persons  even  in  the  ranks  of  the  medical,  dental, 
or  veterinary  profession — and  for  whom  adequate  punishment  should 
be  provided  whenever,  in  the  judgment  of  the  court,  they  have 
abused  their  professional  rights  and  privileges.  As  far  as  the  sup- 
pression of  quackery  is  concerned,  nothing  short  of  a  total  exclusion 
from  the  mails  of  letters,  newspapers,  circulars,  pamphlets,  or  publi- 
cations of  any  kind  containing  any  advertisement  of  secret  remedies 
for  the  cure  and  treatment  of  disease,  will  reach  the  evil.  As  a 
matter  of  fact,  no  physician  should  be  permitted  to  prescribe  by  mail. 

In  view  of  the  importance  of  the  subject,  it  is  recommended  that 
a  special  commission,  composed  of  representatives  of  the  Post-Office 
Department,  Prof.  H.  W.  Wiley,  of  the  Bureau  of  Chemistry,  and 
medical  officers  of  the  Public  Health  and  Marine- Hospital  Service, 
be  appointed  for  the  purpose  of  investigation  and  the  formulation 
of  such  legislation  as  may  be  deemed  necessary  in  the  interest  of 
public  health  and  morals. 


284  REPOBTS  OF  THE  PRESIDENT'S  HOMES  COMMISSION. 

Ill  the  meantime,  it  is  earnestly  recommended  that  the  Postmaster- 
General  be  requested  to  publish  with  the  monthly  supplements  to  the 
Official  Postal  Guide  a  bulletin  setting  forth  the  essential  facts  in 
connection  with  the  fraud  orders  issued  during  the  preceding  months, 
such  bulletins  to  be  posted  in  post-offices  and  to  be  distributed  in 
sufficient  numbers  along  the  rural-delivery  routes.  It  is  also  recom- 
mended that  all  information  concerning  the  harmful  ingredients  in 
foods,  medicines,  soft  and  alcoholic  drinks  which  may  come  to  light 
during  the  execution  of  the  pure  food  and  drugs  law,  be  published 
by  the  Department  of  Agriculture  in  the  same  manner  as  farmers' 
bulletins  are  now  being  published.  The  public  is  entitled  to  be 
warned,  and  for  this  purpose  it  is  essential  that  the  indisputable  facts 
should  emanate  from  some  official  source. 

The  Journal  of  the  American  Medical  Association  has  done  good 
work  in  educating  the  medical  profession,  and  many  of  our  lead- 
ing magazines  have  disseminated  knowledge  of  this  kind  among 
their  readers ;  but,  after  all,  the  masses  must  be  reached  in  the  manner 
indicated,  as  the  majority  of  newspapers  will  not  publish  the  facts. 

Chapter  XL 

SOCIOLOGICAL    STUDY    OP   1,251    FAMILIES. 

[By  G.  H.  Weber,  Statistician  of  the  Commission.] 

SCOPE. 

The  investigation,  which  was  conducted  during  the  months  of 
February  to  June,  inclusive,  covered  a  total  of  1,251  families,  occupy- 
ing 1,054  houses,  and  comprising  5,157  persons.  The  plan  of  the 
commission  was  to  investigate  only  those  families  whose  incomes 
were  below  $1,000  per  annum.  In  some  cases,  where  family  incomes 
were  greater,  but  where  the  families  lived  under  the  same  general 
conditions  and  on  the  same  streets  and  alleys,  they  were  also  in- 
cluded. In  selecting  the  streets,  courts,  and  alleys  the  aim  has  been 
to  take  a  number  of  alleys  where  the  living  conditions  were  worst,  a 
fairly  equal  number  where  they  were  medium,  and  a  corresponding 
number  where  the  conditions  were  the  best.  This  was  done  in  order 
to  give,  as  nearly  as  possible,  a  true  picture  of  the  housing,  social, 
and  economic  conditions  of  these  people  as  a  whole. 

It  has  also  been  the  aim  of  the  commission  to  have  the  investiga- 
tion cover  a  proportion  of  white  and  of  colored  families  equal  to  that 
of  the  total  white  and  colored  families  of  that  class  in  Washington. 

The  following  table  shows,  by  streets  and  sections,  the  number  of 
houses,  families,  and  persons  included  in  the  investigation: 


EEPORTS   OP   THE  PRESIDENT  S  HOMES  COMMISSION. 


285 


WHITE. 

Northwest: 

Twenty-seventh  street 

Cissel  alley 

Temperance  avenue 

Lingers  court 

Potomac  street 

Jackson  Hall  alley 

Valley  street 

Bank  street 

Snow  aUey 

JefEerson  street 

Thirtieth  street 

Purdys  court 


Total. 


Northeast: 

Gales  street 

Twentieth  street. 
Brewers  court . . . 
Pleasant  alley... 
Kjamer  street... 


Total. 


Southeast: 

L  street 

K  street 

Fourteenth  street. 

Twelfth  street 

Fifth  street 

Thirteenth  street. 
Greorgia  avenue... 
Mechanics  place . . 


Total. 


Southwest: 

Rileys  court , 

Twelfth  street 

Maryland  avenue. 

Huntoon  place 

Armory  place 

Union  street 

McLean  street 

Willow  Tree  alley. 

Nolans  court 

F  street 


Total 

Total,  all  sections. 


COLORED. 

Northwest: 

Twenty-seventh  street 

Cissel  alley 

Temperance  avenue 

Lingers  court 

Brainard  street 

Potomac  street 

Jackson  Hall  alley 

Kings  court 

Philips  court 

Cleveland  street 

Shepherd  alley 

Valley  street 

O  street  alley 

Bank  street 

Snow  alley 


Number 
of  houses, 


23 
10 

al 

65 

a  12 

21 

1 

2 

o38 

2 

12 


C127 


Number 

of 
families. 


109 


144 


(«) 


ol86 


d566 


13 

5 

e33 

e27 

7 

/5 

el6 

9 

16 

44 

13 

29 

36 

6 

42 


143 


29 


148 


33 


191 


Number  of  persons. 


Adults. 


64 

29 

2 

4 

25 

53 

66 

3 

5 

134 


436 


104 
27 
33 
12 

116 


292 


372 


558 


594 


Children 

under 
16  years. 


a  Not  including  1  house  occupied  by  both  colored  and  white  persons. 
bNot  including  2  houses  occupied  by  both  colored  and  white  persons. 
eNot  including  6  houses  occupied  by  both  colored  and  white  persons. 
«lNot  including  7  houses  occupied  by  both  colored  and  white  persons, 
« Including  1  house  occupied  by  both  colored  and  white  i)ersons. 
/Including  2  houses  occupied  by  both  colored  and  white  iwrsong. 


227 


220 


301 


1,000 


286 


REPORTS  OF   THE  PRESIDENT  S  HOMES  COMMISSION. 


Number 
ofhouses. 

Number 

of 
families. 

Number  of  persons. 

Adults. 

Children 

under 
16  years. 

Total. 

COLORED— ccntinued. 

Northwest— Continued. 

Goat  alley.                              .  .             .  . 

39 

a  10 

3 

A7 
16 
4 

113 
45 
17 

57 
22 
2 

170 

Jefferson  street 

67 

Johnson  avenue 

19 

Total 

6  353 

m 

1,261 

535 

1,796 

Northeast: 

Gales  street 

6 
12 
11 

6 

15 
11 

16 
46 
22 

6 
34 
17 

22 

Levis  street 

80 

39 

Total 

29 

32 

84 

57 

141 

Southwest: 

Armory  place 

3 

38 

31 

o34 

6 

»8 
41 
49 
46 
10 

»-25 
100 
118 
109 
34 

4 
47 
43 
73 

9 

29 

Van  street 

147 

Willow  Tree  aUey 

161 

Nolans  court 

182 

F  street 

43 

Total 

a  112 

■  M 

386 

176 

562 

Tot^l,  all  sentions 

C494 

d657 

d  1, 731 

768 

2,499 

Total,  white  and  colored 

cl,060 

d  1,251 

d3,389 

1,768 

5,157 

o Including  1  house  occupied  by  both  colored  and  white  persons. 

b  Including  6  houses  occupied  by  both  colored  and  white  persons. 

c  Including  7  houses  occupied  by  both  colored  and  white  persons. 

d  Includes  2  mixed  families,  7  white  and  5  colored  adults  living  together,  all  counted  as  colored. 

Of  the  1,251  families  investigated  594,  or  47^  per  cent,  were  white 
and  52J  per  cent  were  colored,  and  of  the  total  persons  constituting 
these  families  2,658,  or  51J  per  cent,  were  white,  and  2,499,  or  48^ 
per  cent,  were  colored. 


LIVING   CONDITIONS. 

The  poorer  people  of  Washington,  unlike  those  of  most  other  cities, 
live  mainly  in  small  one- family  houses.  This  is  shown  by  the  fact 
that  2,151  families  visited  occupied  1,054  separate  houses.  These 
houses  are  nearly  all  old  two-story  brick  or  frame  buildings  without 
such  modem  conveniences  as  hot  and  cold  water,  bathrooms,  or  inside 
water-closets.  Cases  of  overcrowding  were  common,  especially  among 
the  colored  people,  in  some  instances  as  many  as  eight  or  ten  people 
occupying  one  bedroom  at  night.  Cases  were  also  common  where 
families  crowded  in  one  or  two  rooms  at  night  when  sitting  or  dining 
rooms  could  have  been  utilized  for  sleeping  purposes.  In  general, 
however,  where  apartments  were  small  and  families  large,  all  avail- 
able space,  even  the  kitchens,  were  used  as  bedrooms.  While  the  num- 
ber of  families  keeping  boarders  or  lodgers  was  comparatively  small, 
not  a  few  cases  were  found  where  members  of  families  of  both  sexes, 
old  and  young,  slept  in  the  same  rooms  with  lodgers.  The  moral  and 
sanitary  effects  of  such  conditions  are  obvious. 


KEPORTS    OP    THE  PRESIDENT  S   HOMES   COMMISSION, 


287 


INCOME   AND   EXPENDITURES. 

In  the  case  of  1,217  families,  for  which  fairly  accurate  returns 
were  made  concerning  income  and  expenditures,  476,  or  39  per  cent, 
had  a  family  income  of  $500  or  less  per  annum;  159,  or  13  per  cent, 
had  an  income  of  from  $500  to  $600 ;  153,  or  12^  per  cent,  from  $600 
to  $700 ;  153,  or  12i  per  cent,  from  $700  to  $800 ;  89,  or  7  per  cent,  from 
$800  to  $900 ;  93,  or  8  per  cent,  from  $900  to  $1,000 ;  82,  or  7  per  cent, 
from  $1,000  to  $1,500;  and  12,  or  1  per  cent,  had  an  annual  income  of 
over  $1,500. 

The  average  income  and  expenditures  for  each  of  these  groups  are 
shown  in  absolute  and  relative  figures  in  the  following  tables : 

Average  annual  expenditures  of  one  family. 


Income. 


Num- 
ber 
fami- 
lies in 
class. 


Aver- 
age size 
of  fami- 
lies. 


Average 
income 

per 
family. 


Rent. 


Food. 


Fuel 
and 
light 


Cloth- 
ing. 


Insur- 
ance. 


Sick- 


and 
death. 


Class  A,  $500  or  under 

Class  B,  SoOO  to  S  no 

Class  C,  $000  to  $700 

Class  D,  $700  to  SSOO 

Class  E,  $800  to  S9:)0 

Class  F,  $900  to  $1,000 

Class  G,  $1,000  to  $1,500... 
Class  H,  $1,500  and  upward 


476 
159 
153 
153 
89 
93 
82 
12 


3.11 
3.94 
4.18 
4.40 
4.79 
4.77 
5.48 
4.50 


$351.  35 
546.  31 
638.57 
749.  91 
846. 93 
921.  41 

,  182.  93 


1,899.58 


$72.  69 
97.44 
106.16 
119.  04 
115. 12 
127.  36 
135.  52 
100.58 


$146.85 
220.  55 
265.55 
296.54 
341.65 
340.73 
378.  74 
401.00 


$26.  25 
33.88 
32.18 
38.01 
37.03 
38.91 
41.81 
49.83 


$32.  54 
53.62 
69.  67 
82.75 
97.68 
104. 13 
148.  48 
193. 16 


$12.25 
20.24 
19.05 
16.08 
23.79 
24.22 
31.08 
32.83 


$5.43 
5.05 
6.77 
9.90 

10.51 
8.80 

15.46 

47.83 


Income. 


Class  A,  $500  or  under 

Class  B,  $.500  to  $000 

Class  C,  $600  to  $700 

Class  D,  $700  to  $800 

Class  E,  $800  to  $900 

Class  F,  $900  to  $1,000 

Class  G,  $1,000  to  $1,500... 
Class  H,  $1,500  and  upward 


Num- 
ber 

fami- 
lies in 
class. 


476 
159 
153 
153 
89 
93 
82 
12 


Aver- 
age size 
of  fami- 
lies. 


3.11 
3.94 
4.18 
4.40 
4.79 
4.77 
5.48 
4.50 


Patent 
medi- 
cines. 


$0.97 
1.18 
1.69 
1.35 
1.40 
.97 
3.71 
2.08 


Liquor, 


$8.82 
16.44 
21.08 
18.67 
12.77 
15.31 
14.78 
21.25 


To- 
bacco. 


$4.72 

7.64 
11.10 
13.12 
13.52 
16.25 
12.53 
19.50 


Amuse- 
ment. 


$5.02 
11.27 
14.52 
28.91 
30.95 
41.41 
38.40 
73.00 


Miscel 
laneous 

or 
other 


$34.34 
69.36 
74.23 
82.35 
102.  64 
109.90 
210.  02 
241.16 


Total. 


$349.88 
636.67 
622.00 
706.72 
787. 06 
827.  99 
1,030.53 
1,182.22 


Sur- 
plus. 


$9.64 
16.57 
43.19 
59.87 
93.42 
152.  40 
717.36 


288  EEPOBTS  OF   THE  PKESIDENt's  HOMES  COMMISSION. 

Showing  same  averages  hy  percentage. 


Income. 


Num- 
ber 
fami- 
lies in 
class. 


lies,         ^^^ 


Rent. 


Food. 


Fuel 
and 
light. 


Cloth- 
ing. 


Insur- 
ance. 


Sick- 


and 
death. 


Class  A,  1500  or  under 

Class  B,  $500  to  $600 

Class  C,  S600  to  $700 

Class  D,  $700  to  $800 

Class  E,  $800  to  $900 

Class  F,  $900  to  $1,000 

Class  G,  $1,000  to  $1,500. . . . 
Class  H,  $1,500  and  upward. 


476 
159 
153 
153 
89 
93 
82 
12 


3.11 
3.94 
4.18 
4.40 
4.79 
4.77 
5.48 
4.50 


100.00 
100.00 
100.00 
100.00 
100.00 
100.00 
100.00 
100.00 


21.37 

17.56 
17.17 
15.64 
13.31 
13.60 
10.96 
5.37 


43.68 
43.59 
41.40 
40.21 
41.92 
38.43 
33.38 
21.03 


6.74 
5.41 
4.88 
4.89 
4.33 
4.05 
3.34 
2.77 


8.99 
9.90 
10.53 
11.14 
11.59 
11.70 
11.55 
10.23 


2.80 
3.04 
2.67 
2.27 
2.77 
2.90 
2.39 
1.90 


2.12 
.81 
1.00 
1.40 
1.30 
1.10 
1.34 
3.22 


Income. 

Num- 
ber 
fami- 
lies in 
class. 

Aver- 
age size 
of  fami- 
lies. 

Patent 
medi- 
cines. 

Liquor. 

To- 
bacco. 

Amuse- 
ments. 

Miscel- 
laneous 

or 
other. 

Total. 

Sur- 
plus. 

Class  A,  $500  or  under 

Class  B,  $500  to  $600 

Class  C,  $600  to  $700 

Class  D,  $700  to  $800 

Class  E,  $800  to  $900 

Class  F,  $900  to  $1,000 

Class  G,  $1,000  to  $1,500.... 
Class  H,  $1,500  and  upward. 

476 
159 
153 
153 
89 
93 
82 
12 

3.11 
3.94 

4.18 
4.40 
4.79 
4.77 
5.48 
4.50 

0.29 
.16 
.18 
.18 
.13 
.11 
.23 
.14 

1.97 
2.33 
3.27 
2.32 
1.39 
1.89 
1.41 
.90 

1.21 
1.45 
1.82 
1.71 
1.52 
1.76 
1.19 
1.02 

1.47 
2.76 
2.68 
3.52 
3.43 
3.95 
3.97 
4.00 

7.76 
10.78 
11.20 
10.78 
12.04 
11.89 
14.01 
14.08 

98.39 
97.73 
96.82 
94.10 
93.76 
91.42 
86.29 
64.58 

3.18 
2.42 
3.18 
5.90 
6.28 
8.58 
13.71 
35.42 

Average  weekly  expenses  {per  cent). 


Income. 

Meats. 

Fats. 

Sugar. 

Bread. 

Vege- 
tables. 

Fruit. 

Coffee. 

Tea  or 
cocoa. 

Class  A,  $.500  or  under 

1.13 

1.67 
1.84 
2.16 
2.38 
2.27 
2.76 
3.31 

0.24 
.38 
.38 
.42 
.51 
.51 
.85 
.95 

0.13 
.19 
.18 
.21 
.23 
.22 
.28 
.30 

0.48 
.62 
.65 
.64 
.82 
.74 
1.00 
1.75 

0.53 
.80 
1.06 
1.42 
1.50 
1.65 
1.34 
1.02 

0.16 
.13 
.18 
.22 
.23 
.33 
.35 
.38 

0.13 

.17 
.23 
.27 
.28 
.33 
.35 
.32 

0.07 

Class  B,  $500  to  $600 

.13 

Class  C,  $(J00  to  $700 

.15 

Class  D,  $700  to  $800 

.15 

Class  E,  $800  to  $900 

.18 

Class  F,  $900  to  $1,000 

.20 

Class  G;  $1,000  to  $1,500 

.17 

Class  H,  $1,500  and  upward 

.11 

These  fibres  show  actual  money  received  and  expended.  In  the 
expenditures  no  items  appear  unless  they  represent  money  actually 
paid  out.  Where  items  of  rent,  food,  clothing,  etc.,  were  unpaid  at 
the  close  of  the  year  they  do  not  figure  in  the  expenditures. 

The  average  family,  with  an  income  of  $500  or  less  per  annum, 
expended  about  $6  per  month  for  rent,  this  item  constituting  about  21 
per  cent  of  the  total  family  income.  The  average  monthly  rents  for 
the  other  six  groups  were  about  $8,  $9,  $10,  $9.50,  $10.50,  and  $11, 
respectively.  It  will  be  observed,  by  consulting  the  second  table,  that 
the  proportion  of  income  paid  for  rent  diminishes  steadily  with  the 
increase  in  the  family  income.  Thus,  an  average  family  with  an 
income  of  $500  or  less  expended  21  per  cent  for  rent;  an  average 
family  with  an  income  of  $500  to  $600  expends  17^  per  cent;  $600 
to  $700,  I7i  per  cent;  $700  to  $800,  15f  per  cent;  $800  to  $900,  13i 
per  cent;  $900  to  $1,000  13§  per  cent,  an  average  family  with  an  income 
of  $1,000  to  $1,500,  and  living  in  the  territory  investigated,  expends 
only  about  11  per  cent  of  its  income  for  rent. 


BEPOETS   OF   THE  PBESIDENt's  HOMES   COMMISSION.  289 

In  the  matter  of  food  the  average  family  earning  $500  or  less 
expended  about  $147  per  year,  or  about  44  per  cent  of  the  total  in- 
come. This  proportion  also  decreases  almost  steadily  with  the  increase 
in  income,  the  average  family  in  the  highest  class  paying  propor- 
tionately onlj^  about  21  per  cent  of  its  income  for  food. 

The  same  is  true  with  regard  to  fuel  and  light,  for  which  the 
average  family  of  the  lowest  income  group  pays  $26,  or  6f  per  cent, 
for  fuel  and  light,  while  the  average  family  of  the  highest  income 
group  pays  about  $42,  or  2|  per  cent. 

While  for  these  necessities  of  life,  i.  e.,  shelter,  food,  heat,  and  light, 
the  proportion  of  expenditure  increases  with  the  decrease  of  income, 
it  is  not  so  with  other  items.  In  the  matter  of  clothing,  the  propor- 
tion increases  steadily  from  9  to  about  11 J  per  cent  in  the  first  six 
income  groups,  namely,  those  of  $1,000  and  under,  and  then  decreases 
to  lOJ  per  cent  in  the  highest  income  group.  The  proportion  of  the 
income  paid  for  insurance  varies  irregularly  in  the  different  income 
groups,  being  distinctly  higher,  however,  in  the  case  of  families  with 
incomes  of  less  than  $1,000  than  in  the  case  of  families  whose  incomes 
are  higher.  The  items  of  amusements,  like  that  of  clothing,  increases 
proportionately  with  the  increase  in  family  income.  The  other  items 
of  expenditure  show  no  marked  tendency  to  increase  or  decrease  in 
family  income. 

The  expenditures  for  liquor  and  tobacco,  as  shown  in  the  table,  are 
probably  less  than  those  actually  incurred,  as  all  the  investigators 
report  a  tendency  on  the  part  of  the  families  visited  to  minify  this 
item  of  expense.  As  it  is,  however,  it  shows  that  by  eliminating  this 
useless  expense  an  average  family  earning  $500  or  less  per  annum 
could  save  over  $12  per  year,  which,  if  added  to  the  rent,  would 
materially  improve  the  home  conditions  of  the  family.  In  the  case 
of  the  other  families  with  incomes  of  $1,000  or  less  per  annum,  the 
average  annual  expenditures  for  liquor  and  tobacco  range,  in  the 
different  income  groups,  from  about  $24  to  $32.  Taken  as  a  whole, 
the  families  investigated  could  add  on  an  average  of  at  least  one  room 
each  to  their  overcrowded  homes  if  the  money  expended  for  intoxi- 
cants and  tobacco  were  devoted  to  the  payment  of  rent. 

Sickness  and  death  (including  expenditures  for  patent  medicines) 
caused  an  annual  expenditure  ranging,  in  the  different  income  groups, 
from  about  $6.50  to  $50  per  annum. 

The  surplus  remaining  after  deducting  the  annual  family  expend- 
itures from  the  annual  family  incomes,  as  shown  by  the  income 
groups,  increased  steadily  with  the  family  income,  ranging  in  amount 
from  $6.40  in  the  lowest  group  ($500  per  annum  and  under)  to 
$718.92  in  the  highest  group.  It  must  be  remembered  that  this  last 
group  consists  largely  of  families  who  live  in  the  environments  where 
they  were  found  on  account  of  business  interests,  such  as  families  of 
grocers,  saloon  keepers,  etc.,  or  of  foreign  males  who  maintain 
cooperative  households  and  send  a  large  part  of  their  earnings  to 
their  dependents  abroad. 

The  1,123  families  whose  incomes  were  less  than  $1,000  per  annum 

had  an  average  income  per  family  of  $559  per  year.    Of  this  average 

income,  $435,  or  78  per  cent,  were  expended  for  actual  necessities, 

namely,  for  rent,  food,  fuel,  clothing,  insurance,  sickness,  medicines, 

S.  Doc.  644,  60-2 ^20 


290  KEPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

and  death.  This  leaves  but  $124,  or  22  per  cent,  for  all  other  expendi- 
tures and  for  savings.  Of  this  balance  $23,  or  4  per  cent  of  the  entire 
income,  were  expended  for  intoxicating  liquors  and  tobacco ;  $15,  or  3 
per  cent,  for  amusements;  $63,  or  11  per  cent,  for  miscellaneous; 
leaving  $23,  or  4  per  cent  of  the  average  income,  to  be  laid  aside  as 
savings. 

OCCUPATIONS. 

Of  the  total  occupants  of  the  houses  visited,  the  occupations  of 
2,413  wage-earners  were  ascertained.  Of  these  821  were  white  males, 
708  were  colored  males,  153  were  white  females,  and  731  were  colored 
females.  It  will  be  noticed  that  of  the  white  people  visited  and  whose 
occupations  were  reported,  only  about  17J  per  cent  were  females, 
while  of  the  colored  people  over  one-half  of  the  wage-earners  were 
females. 

Of  the  white  males,  about  42J  per  cent  were  skilled  workers,  such  as 
carpenters,  painters,  machinists,  etc.;  27^  per  cent  were  unskilled 
laborers;  9i  per  cent  were  clerks,  salesmen,"  etc. ;  8  per  cent  were 
peddlers  and  hucksters ;  6 J  per  cent  were  drivers  and  teamsters.  The 
remaining  7J  per  cent  were  shopkeepers,  persons  engaged  in  personal 
or  domestic  service,  and  various  other  occupations. 

Of  the  colored  male  wage-earners,  56J  per  cent  were  unskilled 
laborers;  19^  per  cent  were  drivers  and  teamsters;  7^  per  cent  were 
engaged  in  personal  or  domestic  service;  5f  per  cent  were  skilled 
workers ;  2  per  cent  were  clerks,  salesmen,  etc.,  and  the  remaining  8| 
per  cent  were  in  other  occupations. 

Of  white  female  wage-earners,  38J  per  cent  were  clerks,  saleswomen, 
etc.;  15|  per  cent  were  dressmakers  and  seamstresses;  7|  per  cent 
were  laundresses;  7 J  per  cent  were  engaged  as  cooks  and  domestic 
servants;  6J  per  cent  were  charwomen;  5 J  per  cent  were  shop- 
keepers, and  4  per  cent  were  waitresses  and  dish  washers ;  the  remain- 
ing 15  per  cent  being  employed  as  nurses,  hucksters,  and  in  other 
occupations. 

Of  the  colored  female  wage-earners,  57j  per  cent  were  laundresses ; 
34J  per  cent  were  cooks  and  domestic  servants ;  3  per  cent  were  dress- 
makers and  seamstresses;  2i  per  cent  were  charwomen,  and  the  re- 
maining 2J  per  cent  were  waitresses,  dish  washers,  nurses,  school- 
teachers, shopkeepers,  etc. 

These  occupation  statistics  show  that  the  colored  population  was 
engaged  mainly  in  the  unskilled  manual  occupations  and  in  personal 
or  domestic  service,  while  the  white  population  were  mostly  engaged 
in  somewhat  higher-class  work. 

The  two  following  tables  show  the  number  of  persons  engaged  in 
each  of  the  leading  occupations  in  each  section  of  the  city  and  in  the 
entire  district  covered  by  the  investigation: 


KEPORTS   OF   THE  PRESIDENT  S  HOMES   COMMISSION. 
Occupation  of  males. 


291 


White. 

Colored. 

Occupation. 

o  gJ 

5^ 

it 

1® 

CO  !* 

3  S3 

i 

i 

5 
3 

6 

1 
1 
7 

2 

18 

1 

io 

16 
4 

37 

35 
7 

10 

■■4' 
4 

""'5' 

2 
14 

4 

5 
10 

2 
...... 

39 
109 

16 

28 
1 
5 
1 
1 

21 

3 
11 
3 

17 
2 

15 
2 

■■■42' 

41 

6 

17 

'"'h' 

1 

12 

J5 

25 
13 
34 

18 

12 

168 

226 

46 

76 

5 

65 

17 

5 

39 



12 

Carpenters 

2 
2 

2 
2 

48 

16 

Machinists      .                   

25 

13 

Painters 

2 

2 

36 

18 

Tinners 

7 
50 
41 
17 
21 

4 
48 
11 

4 
13 

12 

Other  skilled  laborers 

23. 

276 

107 

10 

42 

8 

3 

1 

46 

3 
14 
8 
2 
3 

8 

110 

23 

3 

8 

34 

400 

138 

15 

53 

8 

5 

1 

48 

202 

Unskilled  laborers 

626 

Drivers  and  t^arnstprs . . 

184 

Clerks,  salesmen,  etc 

91 

Personal  service 

58 

Peddlers  and  hucksters 

73 

Shop  keepers 

2 

22 

Other  independent  workers 

6 

2 

87 

Total      

239 

155 

259 

168 

821 

522 

32 

154 



708 

1,529 

Occupation  of  females. 


White. 

Colored. 

Occupation. 

0  ^ 

6^ 

II 

!^+i 

5^ 

^ 

4 

15 

""9 

1 

....„ 

5 

3 

18 

1 
8 

""3" 
1 

3 

....„ 

1 
1 

10 
59 
2 

24 
3 

12 
3 

10 

1 

9 

20 

30 

Clerks,  saleswomen,  etc 

59 

Cooks 

61 
13 

...... 

19 
3 

80 
21 

82 

Dressmakers  and  seamstresses 

Hucksters 

10 

45 
3 

3 
2 

324 
4 

13 
1 
2 
4 

81 

1 

418 
6 
2 

170 
2 
6 
6 

430 

Nurses     

9 

School  teachers 

2 

Servants,  domestic 

Shop  keepers 

2 
2 
2 
4 

3 
3 
2 

1 

4 
3 
2 
10 

""2 

9 
8 
6 
17 

143 

23 
2 

1 
1 

179 
10 

Waitresses  and  dish  washers 

Miscellaneous 

5 
5 



12 
23 

Total 

44 

26 

53 

30 

153 

565 

26 

140 



731 

884 

Of  the  total  number  of  white  wage-earners  enumerated,  101,  or 
lOJ  per  cent,  were  reported  as  being  members  of  labor  organizations ; 
and  of  the  colored  wage-earners  only  IJ  per  cent  belonged  to  labor 
unions. 

HOUKS  OF  LABOR. 

The  hours  of  labor  of  these  wage-earners  varied  from  two  to  eight- 
een per  day,  the  number  working  more  than  ten  and  less  than  eight 
being  comparatively  small.  Of  the  total  number  reporting  hours  of 
labor,  25f  per  cent  worked  eight  hours  per  day ;  11^  per  cent  worked 
nine  hours,  and  22  per  cent  worked  ten  hours  per  day.  These,  to- 
gether with  a  small  number  working  eight  and  one-half  and  nine 
and  one-half  hours  per  day,  make  the  total  number  working  from 
eight  to  ten  hours  per  day  equal  to  about  61  per  cent  of  the  persons 
whose  hours  of  labor  were  reported.  Of  the  rest  about  3J  per  cent 
of  the  entire  number  worked  less  than  eight  hours;  22  per  cent 
worked  over  ten  hours,  and  13J  per  cent  worked  at  irregular  hours. 


292 


BEPOKTS  OF   THE  PRESIDENT  S  HOMES  COMMISSION. 


Those  working  over  ten  hours  per  day  were  mainly  colored  laun- 
dresses and  female  domestic  servants. 

The  following  table  shows  the  number  of  white  and  colored  wage- 
earners  classified  according  to  the  number  of  working  hours  per  day : 

Time  employed  per  day. 


White. 

Colored. 

i 

0 
1 

i 

1 

*5 

5 

•3 

1 

% 

1 
55 

1 

1 

1 

|1 

r 

li  hours 

2  hours 

2 

2 

3 

3 

5 

2i  hours 

S  hours 

4 
1 
6 

4 
1 
7 

4 

8i  hours 

1 

1 



1 
1 
1 
4 
2 

2 

4  hours . . 

1 

8 

44  hours 

1 

1 
1 

1 

5  hours 

2 

1 

. .... 

1 

5 

2 

7 

11 

bi  hours 

2 

11 

2 

3 

16 

If. 

6i  hours 

1 
2 
1 

71 

1 
5 

1 

5 

5 

303 

15 

155 

8 

226 

11 

23 

1 

7  hours 

'"'82' 
9 

36 
2 

S3 

3 

4 
86 

4 
30 

6 

115 

11 

6 

1 

84 

'""29' 
....„ 

8 

2 

10 

15 

7i  hours 

6 

8  hours 

131 

4 

60 

2 

165 

1 

41 

8 
...... 

....„ 

...... 

91 
12 

230 

5 

83 

3 

227 

2 

54 

633 

8i  hours . 

20 

9  hours 

238 

9?  hours 

11 

10  hours 

49 

453 

IO5  hours .     . 

13 

11  hours . 

15 

1 

77 

12  hours . . 

13 

1 
2 

7 
2 
3 

9 

29 
3 
8 

172 

13 

37 

3 

1 

6 

3 

....„ 

73 
3 

\ 

1 

251 

19 

40 

7 

2 

280 

13  hours 

22 

14  hours 

2 

1 

48 

15  hours 

7 

' 

1 

2 

4 

17  hours . 

1 
26 

1 
154 

2 
89 

1 
15 

3 

127 

4 

Irregular 

57 

71 

23 

281 

Total 

224 

186 

349 

201 

960 

759 

46 

2% 



1,101 

2,061 

EMPLOYMENT. 

In  the  case  of  2,439  wage-earners  returns  were  maiXe  concerning 
the  continuance  of  employment  during  the  year  covered  by  the  in- 
vestigation. Of  these,  993  were  white  and  1,446  were  colored  wage- 
earners. 

Of  the  white  wage-earners,  581,  or  58 J  per  cent,  were  employed  the 
entire  year;  42,  or  4J  per  cent,  were  idle  an  average  of  11  weeks  on 
account  of  illness,  and  370,  or  37J  per  cent,  were  idle  an  average  of 
16J  weeks  for  other  reasons.  Of  the  whole  number  of  white  wage- 
earners  (including  those  working  full  time)  the  average  time  lost 
during  the  year  was  about  6J  weeks  out  of  the  52. 

The  colored  wage-earners  show  a  larger  proportion  of  unemploy- 
ment, if  the  latter  is  measured  by  the  number  of  persons  idle,  but  the 
average  time  lost  of  all  colored  wage-earners  is  almost  the  same  as 
that  of  the  white.  Thus,  of  1,446  colored  wage-earners,  634,  or  43} 
per  cent,  worked  the  full  52  weeks;  161,  or  llj  per  cent,  were  idle  an 
average  of  5.4  weeks  on  account  of  sickness,  and  651,  or  45  per  cent, 
were  idle  an  average  of  13.4  weeks  for  other  reasons.  The  average 
period  of  idleness  of  aU  colored  wage- earners  was  a  little  less  than 


EEPORTS   OF   THE  PRESIDENT  S  HOMES   COMMISSION. 


293 


6J  weeks.  It  appears,  therefore,  that  while  the  white  wage-earners 
are  more  steady  in  their  employment,  their  periods  of  unemploy- 
ment, both  on  account  of  illness  and  for  other  rea^ns,  are  longer 
than  those  of  the  colored  wage-earners. 

The  figures  of  unemployment  are  shown  by  color  and  geographical 
section  in  the  following  table : 

WeeJcs  employed. 


05  S  ^ 

Wage-earners  idle  on 
aceouut  of  illness. 

Wage-earners  Idle  for 
other  reasons. 

Num- 
ber. 

Total 
weeks 
idle. 

Weeks 
idle  per 
person. 

Num- 
ber. 

Total 
weeks 
idle. 

Weeks 
idle  per 
person. 

WHITE. 

Northwest 

268 
177 
342 
206 

158 

80 

204 

139 

12 
13 
15 
2 

Ill 

190 

148 

16 

9.3 

14.7 
9.8 
8.0 

98 

84 

123 

65 

1,627 
1,569 
1.834 
1,039 

16.6 

Northeast                                        

18.7 

Southwest 

15.0 

Southeast .         .    . 

16.0 

Total 

993 

581 

42 

465 

11.1 

370 

6,069 

16.4 

COLORED. 

Northwest 

1,088 

57 

301 

611 
43 
80 

122 

1 
38 

673 
5 

199 

5.5 
5.0 
5.2 

455 
13 
183 

6,869 

150 

1,694 

15.1 

Northeast 

11.5 

Southwest 

9.3 

Southeast 

Total 

1,446 

635 

161 

877 

5.4 

651 

8,713 

13.4 

Total  white  and  colored 

2,439 

1,215 

203 

1,342  1        6.6 

1,021 

14,782 

14.5 

Average  weeks  idle  per  wage-earner : 

White 6.5 

Colored 6.  6 

The  reasons  given  for  unemployment  are  very  meager,  the  persons 
visited  being  generally  averse  to  answering  this  inquiry.  In  the  case 
of  white  wage-earners,  the  reasons  given  were  inability  to  secure 
work  in  43  cases ;  illness  in  42  cases ;  old  age  in  4  cases ;  drunkenness 
in  3  cases;  bad  weather  in  3  cases,  and  laziness  in  1  case.  Among 
the  colored  people  the  causes  assigned  were  illness  in  161  cases;  in- 
ability to  secure  work  in  62  cases;  laziness  in  11  cases;  bad  weather 
in  11  cases;  old  age  in  8  cases;  drunkenness  in  5  cases;  incapacity  in 
2  cases,  and  lack  of  skill  in  1  case. 

wage-earners'  lunches. 

Inquiries  concerning  the  meals  of  wage-earners  brought  out  the  in- 
formation that  in  678  cases  they  were  compelled  to  eat  cold  victuals, 
750  carried  dinner  pails,  and  205  were  reported  as  being  accustomed 
to  consume  alcoholic  beverages  with  their  meals.  The  number  in 
each  case  was  greater  among  the  white  than  among  the  colored  wage- 
earners. 


SICKNESS. 

The  returns  concegrning  illness  show  that  of  a  total  population  of 
5,157  persons  enumerated,  there  had  been  613,  or  12  per  cent,  sick 
during  the  past  year.  It  is  very  likely,  however,  that  in  this  enumer- 
ation many  cases  of  slight  illness  had  been  forgotten  by  the  families 
when  visited,  as  the  actual  sickness  rate  must  have  been  much  higher. 
This  rate  was  considerably  higher  among  the  colored  than  among 


294 


REPORTS   OF  THE  PRESIDENT  S   HOMES  COMMISSION, 


the  white  population.  The  average  duration  of  sickness  per  case  was 
reported  to  be  29J  days  for  a  total  of  607  cases.  The  average  dura- 
tion of  illness  was  reported  to  be  much  longer  in  the  case  of  colored 
than  of  white  persons,  namely,  22.4  days  and  35.6  days,  respectively. 

The  deaths  reported  during  the  past  year  were  likewise  surpris- 
ingly few,  although  the  investigators  made  a  special  effort  to  obtain 
complete  returns.  Thus,  there  were  reported  but  23  deaths  among 
the  white,  and  34  deaths  among  the  colored  population,  making  a 
death  rate  of  9  and  13  per  1,000  respectively,  figures  which  are  ob- 
viously too  low.  The  most  frequent  causes  of  death  reported  were 
tuburculosis,  11  cases;  pneumonia,  7  cases;  heart  disease  and  indi- 
gestion, each  4  cases. 

The  cases  of  permanent  disability  as  shown  by  the  returns  are  com- 
paratively few,  namely,  42.  The  age  was  reported  in  39  cases,  of 
which  3  were  persons  19  years  of  age  or  under;  14  persons  20  to  49 
years;  19  persons  50  to  79  years,  and  3  persons  80  years  of  age  or 
over.  The  most  frequent  causes  of  permanent  disability  were  rheuma- 
tism, 8  cases ;  senility,  7  cases,  and  tuberculosis,  5  cases. 


INSURANCE. 

A  surprisingly  large  number  of  persons  were  found  to  carry  life  or 
sick  insurance.  Iii  tabulating  insurance  returns  only  members  of 
families,  exclusive  of  boarders  and  lodgers,  were  considered,  because 
such  returns  concerning  the  latter  would  necessarily  be  incomplete. 
It  was  found  that  of  a  population  of  4,889,  2,202,  or  45  per  cent,  car- 
ried life  insurance  of  some  sort,  and  855,  or  17J  per  cent,  carried  in- 
surance against  sickness.  The  insurance  was  almost  entirely  carried 
in  either  industrial  insurance  companies  or  in  fraternal  or  other 
mutual  benefit  associations,  and  the  premium  payments  were  usually 
made  in  weekly  installments.  About  the  same  proportion  of  white 
and  colored  persons  carry  this  insurance,  although  there  were  pro- 
portionately more  white  carrying  life  insurance  and  proportionately 
more  colored  people  carrying  sick  insurance.  The  next  table  gives 
the  details  by  color  and  geographical  sections : 


1 
1 

Members  of  fami- 
lies,   exclusive 
of  boarders  and 
lodgers. 

Members  of 
families  carrying— 

Entire  city. 

^1 

Sick 
insurance. 

WHITE. 

Northwest 

143 
112 
148 
191 

611 
501 
620 
861 

863 
831 
160 
851 

27 

Northeast...                   .                                   

25 

Southeast 

7 

Southwest 

81 

Total . . . 

694 

2,693 

1,195 

90 

COLOEED. 

Northwest 

471 
82 

1,664 
127 

720 
41 

691 

Northeast 

84 

Southeast 

Southwest 

166 

605 

246 

140 

Total 

657 

2,296 

1,007 

765 

Grand  total 

1,251 

4,889 

2,202 

855 

EEPORTS   OP   THE  PRESIDENT  S  HOMES   COMMISSION. 


295 


INSTALLMENT  PAYMENTS. 

The  investigators  found  it  exceedingly  difficult  to  obtain  informa- 
tion concerning  installment  payments  on  furniture,  clothing,  and 
money  borrowed,  and  in  many  cases  the  families  refused  to  answer 
this  inquiry.  The  returns,  therefore,  are  necessarily  somewhat 
meager. 

Transactions  of  this  kind  were  found  to  be  much  more  frequent 
among  the  colored  than  among  the  white  population.  Of  136  fami- 
lies who  answered  affirmatively  the  inquiry  concerning  furniture 
purchases  on  the  installment  plan,  35  were  white  and  66  were  colored. 
The  total  cost  of  the  furniture  so  purchased  was  greater,  however, 
in  the  case  of  the  white  than  of  the  colored  people,  namely,  $3,235 
and  $2,871,  respectively.  Under  furniture  were  also  included  one 
watch,  one  graphophone,  and  four  pianos.  Clothing  was  reported 
purchased  on  the  installment  plan  in  5  cases  of  white  and  8  cases  of 
colored  families,  the  total  cost  of  the  clothing  being  $121  and  $162, 
respectively.  The  furniture  and  clothing  installment  payments  were 
usually  made  weekly. 

LOAN    COMPANIES. 

The  practice  of  borrowing  money  for  repayment  on  the  installment 
plan  appears  to  have  been  confined  mostly  to  the  colored  people,  only 
3  white  families  having  reported  such  transactions  as  against  26 
colored  families.  The  total  amount  borrowed  in  this  way  was  $130 
by  the  white,  and  $420  by  the  colored  families.  It  was  not  possible 
in  all  these  cases  to  ascertain  the  terms  of  repayment  upon  which 
these  loans  were  made,  but  a  sufficient  number  of  cases  is  given  below 
to  show  the  exorbitant  rates  paid  for  the  same: 


Amount 

Monthly 

Number 

Amount 

Charges. 

borrowed. 

payments. 

of  months. 

repaid. 

m 

$3.50 

6 

$21.00 

$6.00 

14 

3.40 

6 

20.40 

6.40 

20 

3.00 

8 

24.00 

4.00 

15 

O.70 

a46 

32.20 

17.20 

10 

2.60 

6 

15.60 

5.60 

10 

2.95 

6 

17.50 

7.50 

10 

2.20 

8 

17.60 

7.60 

15 

2.65 

10 

26.50 

11.50 

20 

8.50 

10 

35.00 

15.00 

25 

3.80 

10 

38.00 

13.00 

10 

2.25 

8 

18.00 

8.00 

15 

3.00 

6 

18.00 

8.00 

15 

3.70 

6 

22.20 

7.20 

25 

4.50 

9 

40.50 

15.50 

15 

2.75 

9 

24.75 

9.75 

10 

3.00 

6 

18.00 

8.00 

10 

O.70 

o28 

19.60 

9.60 

15 

2.70 

9 

24.30 

9.30 

25 

6.10 

6 

36.60 

11.60 

6 

2.60 

2* 

6.50 

1.60 

a  Weekly. 
ILLITERACY. 


In  tabulating  the  statistics  of  illiteracy  only  those  persons  were  con- 
sidered who  had  passed  the  school  age,  namely,  14  years  and  over. 
Of  4,161  such  persons,  502,  or  12.1  per  cent,  were  unable  to  read  or 


296 


EEPORTS  OF   THE  PRESIDENT  S  HOMES  COMMISSlOlT. 


write.  The  percentage  of  illiteracy  was  more  than  three  times  as 
great  among  the  colored  than  among  the  white  population,  namely, 
17.5  and  5.4  per  cent,  respectively.  In  the  case  of  both  white  and 
colored  the  percentage  of  illiteracy  was  greater  among  the  males  than 
among  the  females.  The  following  table  shows  the  data  concerning 
illiteracy  by  sex  and  color  for  each  section : 


Total  persons  14  years  of  age 
and  over. 

Illiterates  14  years  of  age  and 
over. 

Male. 

Female. 

Both 
sexes. 

Male. 

Female. 

Both 
sexes. 

■WHITE. 

Northwest .       

310 
154 
189 
323 

264 
155 
195 
280 

574 
309 
384 
603 

30 
3 

1 
38 

20 
5 

50 

Northeast 

8 

Southeast 

I 

Southwest 

4 

42 

Total 

976 

894 

1,870 

72 
7.37 

29 
3.24 

101 

Per  cent 

5  40 

COLORED. 

Northwest 

523 
42 

689 
48 

1,212 
90 

102 
3 

169 
8 

271 

Northeast 

10 

Southeast 

Southwest 

176 

490 

989 

62 

58 

120 

Total 

741 

1,227 

2,291 

167 
22.5 

235 
19.1 

401 

Per  cent 

17  5 

Grand  total 

1,717 

2.121 

4,161 

239 
13.9 

264 
12.4 

502 

Percent 

12  1 

SCHOOL  ATTENDANCE. 


Figures  showing  school  attendance  are  given  in  the  next  table 


Children  7  to  14  years  of  age. 

P  bo 

a 

SI'S 

4!> 

c3 

Total. 

Attending  school. 

Not  at- 
tend- 
ing 
school. 

•^8 

s| 

II 

ill 

i    "■ 

Si 

3 

O60 

a 

WHITE. 

Northwest 

no 

102 
162 
123 

2 

4 
3 

39 

8 

9 
3 

54 

92 

79 

110 

64 

101 
91 
153 
118 

8 
11 
10 

5 

6 

12 

7 

5 

10 

Northeast 

13 

1 

13 

Southeast 

10 

Total 

497 

1 

2 

46 

69 

345 

463 

34 

30 

4< 

GOLOBED. 

Northwest 

249 

32 
110 

1 

80 

7 

1 
2 

167 
28 
82 

205 

29 

100 

44 
3 
10 

10 

i 

26 

Northeast 

5 

2 



14 

12 

Southeast 

Total 

391 

3 

44 

10 

277 

834 

57 

18 

43 

Grand  total . . 

888 

4 

2 

90 

79 

622 

797 

91 

48 

89 

EEPORTS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  297 

It  will  be  observed  that  a  considerable  number  of  children  of  com- 
pulsory school  age  were  found  who  had  either  not  attended  school  at 
all  during  the  past  year  or  who  attended  less  than  one-half  of  the 
school  term.  Thus,  91  children  from  7  to  14  years  of  age  had  been 
kept  out  of  school  the  entire  year,  and  96  were  in  school  less  than 
twenty  weeks  during  the  year.  Those  not  attending  at  all  were 
mostly  colored  children.  On  the  other  hand  48  children  under  7 
years  and  89  children  over  14  years  of  age  were  found  attending 
school.  In  40  cases  children  were  kept  out  of  school  some  time  during 
the  year  on  account  of  a  lack  of  the  necessary  clothing.  Of  these  7 
were  white  and  33  were  colored  children. 

Chapter  XII. 

THE  BUSINESS  RELATIONS  OF  WAGE-EARNERS. 

[By  James  Bbonson  Reynolds.] 

In  proportion  as  wealth  increases  devices  for  its  protection  increase 
in  number,  quality,  and  efficiency.  As  wealth  diminishes  its  safe- 
guards diminish.  When  extreme  poverty  is  reached  the  supposed 
agencies  of  protection  are  frequently  not  only  nonprotective,  but 
actually  predatory.  Among  such  are  employment  agencies  where 
the  wage-earner  seeks  work;  pawn  shops  and  loan  companies  for 
the  wage-earner's  borrowing;  industrial  insurance  companies  and 
mutual  benefit  societies  for  his  saving,  and  installment-payment  con- 
cerns where  he  purchases  on  credit. 

Believing  that  the  regulation,  protection,  and  promotion  by  the 
government  of  these  instrumentalities  are  quite  as  important  to  the 
industrial  class  as  the  protection  of  the  home  and  the  workshop 
through  sanitary  and  factory  legislation,  this  commission  has  in- 
dorsed the  recommendations  made  to  the  President  by  the  writer 
that  a  new  department  of  housing  and  labor  be  created  to  have  direct 
and  complete  supervision  of  these  business  enterprises.  This  pro- 
posed department  would  not  merely  exercise  the  powers  of  restraint 
at  present  intrusted  chiefly  to  the  police,  but  in  addition  would  pro- 
mote efficiency  of  service. 

In  view  of  the  recommendation  above  mentioned^  it  is  appropriate 
to  indicate  the  present  condition  of  these  enterprises  and  to  state  the 
character  and  extent  of  the  improvements  advocated. 

EMPLOYMENT  AGENCIES. 

There  were  formerly  about  25  employment  agencies  in  the  District. 
They  were  nominally  under  the  control  of  the  police,  but  a  careful 
investigation  showed  that  the  police  gave  them  very  slight  attention 
unless  specific  complaints  were  presented.  Most  of  these  agencies 
were  indifferent  to  the  character  and  occupation  of  the  employers  to 
whom  they  sent  employees.  This  was  especially  true  in  regard  to 
domestic  agencies.  The  agencies  which  placed  laborers  took  advan- 
tage of  the  applicants  through  fraud  and  misrepresentation  and 
were  careless  in  the  fulfillment  of  their  obligations  to  employers  and 
employees. 


298  EEPORTS  OF  THE  PRESIDENT'S   HOMES  COMMISSION. 

The  present  employment  agency  law,  passed  in  1907,  while  inade- 
quate in  some  respects,  has  produced  a  decided  improvement  in  the 
service  and  paved  the  way  for  further  progress.  At  present  there 
are  only  eleven  licensed  employment  agencies.  Before  taking  out  a 
license  an  agent  must  give  a  bond  and  furnish  evidence  of  ability  to 
carry  on  the  business  in  proper  manner.  The  character  of  the  appli- 
cant is  investigated  by  the  police  department.  These  agencies  have 
been  inspected  at  frequent  intervals  in  the  past,  and  with  the  begin- 
ning of  the  new  license  year  the  inspection  will  be  made  monthly. 
Complaints  against  agencies  under  the  present  law  are  investigated 
by  the  District  Commissioners.  During  the  past  year  nine  hearings 
were  granted  to  persons  bringing  charges  against  employment  agen- 
cies. 

This  service  is  probably  as  good  as  could  be  obtained  under  the 
existing  law,  but  there  are  two  serious  defects  in  the  law. 

1.  Supervision  by  the  police  is  inadequate.  The  work  of  the  police 
must  inevitably  be  confined  to  penal  offenses.  The  regulation  and 
supervision  of  the  efficiency  of  employment  agencies  is  necessary  and 
should  be  performed  by  some  properlj  constituted  public  authority. 

The  effective  distribution  of  labor  is  of  such  supreme  importance 
to  the  entire  community  that  either  employment  agencies  must  receive 
competent  public  supervision,  or  the  European  method  of  government 
employment  agencies,  such  as  those  of  France  and  Germany,  should 
be  adopted.  This  commission  has  preferred  to  adopt  the  more  con- 
servative alternative. 

2.  Complaints  should  be  tried  not  by  the  head  of  the  Distirct  gov- 
ernment, as  at  present,  but  by  the  official  having  direct  oversight  of 
the  agencies.  If  the  proposed  department  of  housing  and  labor 
were  established,  the  chief  of  the  appropriate  bureau  or  the  head 
of  the  department,  both  of  whom  would  be  closely  in  touch  with  the 
service,  should  be  the  proper  parties  to  conduct  investigations  and 
trials. 

PAWN  SHOPS. 

There  are  at  present  eight  pawn  shops  in  the  District  of  Columbia. 
The  legal  rate  of  interest  charged  is  3  per  cent  a  month.  The  present 
law  has  some  excellent  features.  A  report  on  articles  pawned  is 
made  daily  to  the  police,  and  pawn  shops  are  directly  connected  with 
police  headquarters  by  an  electric  call  bell.  The  records  are  open  at 
all  times  to  police  inspection,  and  a  proper  bond  must  be  filed  to 
secure  the  observance  of  the  law  and  the  recovery  on  judgments 
against  pawnbrokers. 

The  pawn  shop  is  the  only  public  agency  for  lending  money  to 
which  the  poor  can  resort,  and  since  it  is  likely  that  recourse  thereto 
will  occur  m  times  of  extreme  need,  the  terms  of  lending  should  be  as 
moderate  as  circumstances  will  permit.  It  is  commonly  supposed 
that  the  pawnbroker  lends  as  little  as  possible  on  articles  pawned. 
Careful  inquiry  and  investigation  reveal  the  fact  that  the  high  rate 
of  interest  disposes  the  pawnbroker  to  lend  as  much  as  possible. 
As  the  pawnbroker  takes  advantage  of  the  improvidence  of  the  bor- 
rower and  derives  his  profit  from  the  interest  charge,  he  determines 
the  amount  to  be  advanced  by  his  estimate  of  the  likelihood  of  the 
redemption  of  the  article  pawned.  If  a  lower  rate  of  interest  were 
charged,  a  smaller  sum  would  be  loaned,  but  a  lighter  burden  would 


KEPORTS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  299 

be  imposed  on  the  borrower.  The  experience  of  the  Provident  Loan 
Society  of  New  York  City,  which  has  rendered  most  important 
service  to  the  community,  is  suggestive.  Regular  New  York  pawn 
shops  charging  3  per  cent  a  month  for  the  first  six  months,  and  2  per 
cent  thereafter,  report  that  from  70  to  80  per  cent  of  the  articles 
pawned  are  redeemed.  The  Provident  Loan  Society,  charging  but 
1  per  cent  a  month,  reports  that  from  98  to  99  per  cent  of  articles 
pawned  are  redeemed.  It  is  probable  that  the  loans  made  by  the 
Provident  Loan  Society  on  given  articles  are  frequently  less  than 
corresponding  loans  made  by  the  pawn  shops.  The  policy  of  the 
Provident  Loan  Society,  however,  encourages  redemption  of  valuable 
articles,  while  that  of  the  average  pawn  shop  encourages  improvir 
dence  with  ultimate  heavy  loss.  Such  features  in  the  conduct  of 
pawn  shops  merit  the  careful  attention  of  public  authorities  quite  as 
much  as  do  the  discovery  and  return  of  stolen  articles,  now  the  main 
concern  of  the  police. 

LOAN   COMPANIES. 

There  are  no  official  statistics  regarding  loan  companies  in  the 
District.  Their  number  is  variously  estimated  to  be  from  50  to 
80.  They  are  wholly  without  public  supervision,  though  Commis- 
sioner West  states  that  ''  the  question  of  licensing,  regulating,  and 
inspecting  these  loan  companies  is,  in  my  judgment,  one  of  the 
most  important  matters  to  be  accomplished."  During  the  last  ses- 
sion of  the  Congress  a  measure  was  drafted  at  the  request  of  Com- 
missioner West  by  the  corporation  counsel  of  the  District  and 
introduced  in  both  Houses.  Investigations  made  by  Commissioner 
West  showed  that  these  companies  sent  out  circulars  to  school  teach- 
ers, department  clerks,  and  others,  urging  them  to  borrow  money. 
The  natural  result  of  this  solicitation  was  to  stimulate  the  borrowing 
habit.  It  was  also  reported  to  this  commission  by  various  chiefs  of 
the  National  Government  that  their  subordinates  were  frequently 
led,  through  the  plausible  representations  of  the  companies,  to  reck- 
less borrowing,  leading  to  subsequent  embarrassment.  It  is  beyond 
question  that  such  companies  render  a  necessary  service,  but  they 
should  be  so  supervised  and  controlled  by  public  authority  that  their 
transactions  would  be  beneficial  instead  of  debauching. 

The  borrowing  of  money  for  repayment  on  the  installment  plan, 
found  in  the  investigation  of  this  commission  to  be  confined  mostly 
to  colored  people,  is  a  device  of  certain  loan  companies  which  merits 
the  most  careful  scrutiny.  It  was  not  possible  in  all  the  cases  investi- 
gated to  ascertain  the  terms  of  repayment  upon  which  loans  were 
made,  but  a  sufficient  number  were  secured  to  show  that  exorbitant 
rates  were  charged. 

INSURANCE. 

When  the  department  of  insurance  was  created  January  1,  1902, 
the  superintendent  found  eleven  companies  undertaking  industrial 
or  sickness,  accident,  and  death  insurance.  Seven  of  these  were 
District  of  Columbia  corporations.  They  had  19,661  policies  in  force, 
representing  $656,917  worth  of  insurance.  The  four  foreign  cor- 
porations had  4,978  policies  in  force,  representing  $179,587  worth 
of  insurance. 


300  REPORTS  OP  THE  PRESIDENT'S  HOMES  COMMISSION. 

The  superintendent  at  first  refused  to  relicense  them,  but  subse- 
quently, recognizing  that  it  would  be  a  hardship  to  thousands  of  in- 
nocent policyholders  to  deprive  them  of  their  insurance,  consented 
to  grunt  licenses.  At  the  present  time  nearly  all  of  the  companies 
refuse  to  pay  the  tax  on  their  premium  receipts,  and  consequently 
they  are  not  licensed  or  examined  pending  the  final  decision  by  the 
court  of  their  obligation  to  be  taxed. 

There  is,  however,  supervision  over  the  Metropolitan,  Prudential, 
and  other  large  insurance  corporations  which  obey  the  law  as  con- 
strued by  the  department.  The  lack  of  law  governing  the  industrial 
assessment  companies  is  fully  appreciated  by  the  Commissioners,  and 
various  bills  to  remedy  existing  deficiencies  have  been  introduced  at 
the  request  of  the  Commissioners  and  of  the  insurance  department. 
As  insurance  is  one  of  the  most  notable  agencies  for  the  encourage- 
ment and  practice  of  saving  and  thrift,  its  thorough  supervision  is 
highly  in  the  public  interest. 

We  also  believe  that  the  friendly  or  mutual  benefit  societies  which 
are  under  public  supervision  in  most  European  countries  should  be 
under  government  inspection  in  the  District.  Such  inspection  would 
undoubtedly  be  in  the  interest  and  to  the  advantage  of  the  members 
of  such  societies,  but  as  many  organizations  prefer  their  independ- 
ence without  interference,  rather  than  the  protection  aiforded  by  gov- 
ernment supervision,  it  might  be  sufficient  to  provide  that  the  super- 
intendent of  insurance  should  have  power  to  inspect  and  report  the 
condition  and  solvency  of  such  organizations  upon  the  request  of  the 
officers  or  of  a  certain  number  of  members  paying  dues  and  eligible 
to  benefits. 

INSTALLMENT   PAYMENTS. 

The  purchase  of  articles  on  the  installment  plan  offers  undeniable 
advantages  to  people  with  limited  means,  and  especially  to  those 
beginning  housekeeping  with  small  capital  and  no  reserve.  It  must, 
therefore,  be  regarded  as  an  established  and  valuable  feature  of  the 
business  relations  of  the  wage-earning  class.  Abuses  under  the  sys- 
tem are,  however,  not  infrequent  and  impositions  are  often  practiced. 
Some  measure  of  public  supervision  should  be  exercised  over  such 
transactions,  at  least  to  the  extent  of  requiring  that  concerns  doing 
business  on  this  plan  should  be  registered  and  their  transactions  sub- 
ject to  the  scrutiny  of  the  department  of  housing  and  labor. 

Chapter  XIII. 

THE  SCALE  OF  WAGES  AND  THE  COST  OF  LIVING. 

[By  Geo.  M.  Kobeb,  M.  D.] 

The  Bureau  of  Labor  has  conducted  an  investigation  on  the  subject 
of  wages  based  on  a  large  number  of  establishments  in  the  chief  manu- 
facturing and  mechanical  industries  in  the  United  States.  The  re^ 
suits  are  set  forth  in  Bulletin  77,  July,  1908. 

The  retail  prices  of  food  are  shown  in  a  succeeding  article  of  the 
bulletin.  From  these  investigations  we  learn  that,  with  the  single 
exception  of  the  year  1907,  the  scale  of  wages  per  hour  has  increased 
with  the  increased  cost  of  living.     In  brief,  wages  in  1907  were  28.8 


EEP 


ORTS   OF   THE  PRESIDENT  S  HOMES  COMMISSION. 


301 


per  cent  higher  than  the  average  for  the  entire  period  from  1890- 
1899,  or  31.6  higher  than  in  1894,  the  year  of  lowest  wages.  The 
variation  in  the  purchasing  power  of  wages  may  be  measured  by  using 
the  retail  prices  of  food,  the  expenditures  for  which  constitute  nearly 
half  of  the  expenditures  for  all  purposes  in  a  workingman's  family. 
From  this  study  we  learn  that  the  retail  price  of  the  principal  article 
of  food  weighted,  according  to  family  consumption  of  the  various 
articles,  was  20.6  per  cent  higher  in  1907  than  the  average  price  paid 
for  the  ten  years'  period  1890-1899,  or  26.3  per  cent  higher  than  in 
1896,  the  year  of  the  lowest  prices  during  the  same  period.  Com- 
pared with  the  average  for  the  same  year  period  the  purchasing 
power  of  an  hour's  wages  in  1907,  as  measured  in  the  purchase  of 
food,  was  6.8  per  cent  greater  than  in  the  decade  1890-1899. 

The  differences  between  1906  and  1907  are  set  forth  as  follows :  In 
the  year  1907  the  average  wages  per  hour  in  the  principal  manufac- 
turing and  mechanical  industries  of  the  country  were  3.7  per  cent 
higher  than  in  1906,  and  the  retail  prices  of  food  were  4.2  per  cent 
higher  in  1907  than  in  1906,  indicating  that  the  purchasing  power  .of 
an  hour's  wages,  as  measured  by  cost  of  food,  was  one-half  of  1  per 
cent  less  in  1907  than  in  1906. 

Unfortunately  all  of  these  valuable  data  are  based  upon  a  study  of 
industries  in  which  skilled,  and  presumably  organized,  wage-earners 
are  employed,  who,  it  may  be  presumed,  have  insisted  upon  an  equit- 
able basis  of  wages.  The  writer  fears  that  the  great  army  of  the 
working  classes  earning  $10  or  less  a  week  have  not  participated  to 
the  same  extent  in  the  general  advance  of  wages,  and  yet  have  had  to 
carry  the  burden  of  increased  cost  of  living. 

The  following  table  shows  the  articles  for  which  the  price  in  1907 
was  higher  than  the  average  price  for  the  decade  of  1890-1899,  and 
also  the  articles  for  which  the  price  in  1907  was  lower  during  the 
same  period : 


Article. 


Bread,  wheat 

Vinegar 

Tea 

Molasses 

Rice 

Beef,  salt 

Milk,  fresh,  unskimmed 

Flour,  wheat 

Beans,  dry 

Beef,  fresh: 

Roasts 

Steaks 

Fish,  fresh 

Potatoes,  Irish 

Fish,  salt 

Cheese 


Relative 
price, 
1907. 


104,5 
104.5 
105.3 


107. 
108. 
114. 
116. 
117. 


118.8 

119.1 
120.6 
120.6 
120.6 
121.6 
123.2 


Article. 


Apples,  evaporated 

Veal 

Butter 

Mutton 

Pork,  salt  (ham) 

Chicken  (year  or  more  old) ,  dressed 

Corn  meal 

Lard 

Eggs 

Pork: 

Salt,  dried,  or  pickled 

Fresh 

Pork,  salt  (bacon) 

Sugar 

Coffee  

Prunes 


Relative 
price, 
1907. 


124.6 
125.0 
127.6 
130.1 
130.7 
131.4 
131.6 
134.2 
137.7 

142.2 
142.5 
157.3 
99.6 
95.0 
88.4 


It  is  especially  deplorable  that  there  should  have  been  such  a 
marked  advance  in  the  necessaries  of  life,  such  as  meats,  beans,  pota- 
toes, corn  meal,  and  pork  or  bacon,  which  with  bread  constitute  the 
foundations  of  a  substantial  diet  for  wage-earners. 

The  bulletin  does  not  take  into  consideration  the  items  of  clothing 
and  dry  goods.    The  cost  of  clothing,  according  to  a  recent  report  of 


302 


BEPOBTS   OF   THE  PKESIDENT's  HOMES  COMMISSION. 


the  chamber  of  commerce,  since  1900  has  advanced  30  per  cent,  ging- 
ham 30  per  cent,  bleached  cotton  goods  60  per  cent. 

The  tables  on  pages  197-200  are  also  of  extreme  interest;  for  in- 
stance, the  table  on  page  197,  based  on  the  average  food  cost  of  2,567 
families,  distributed  over  five  geographical  divisions  in  the  United 
States,  shows  that  the  average  cost  of  food  for  each  family  in  1890 
was  $318.20.  In  1896,  the  year  of  lowest  prices,  it  fell  to  $296.76, 
since  which  time  it  has  gradually  risen  to  $374.75  in  1907. 

The  tables  on  pages  199  and  200  show  the  purchasing  power  of  a 
dollar  from  1890  to  1907  of  various  articles  of  food  of  the  grade  used 
by  the  2,567  workingmen's  families.  Some  of  the  principal  items  are 
here  reproduced  in  a  condensed  form : 


1890. 

1907. 

Fresh  beef 

7.81 
10.06 

9.89 
10.09 

6.33 
16.74 

4.23 

6.39 
10.86 
46.57 

1.22 

6.47 
8  59 

Salt  beef 

.      do 

Fresh  pork 

do.... 

6  73 

Fish.. 

do 

8  63 

Egrg'g                                                                                    

dozen 

8.89 
14  40 

i^ ::::::::::::::::::::::::::::::::::::::: 

Butter    . .          . .              .           

. .  . .          .     .            .                       pounds 

3  29 

Cheese 

do 

6  12 

Lard 

do 

7  95 

Com  meal 

do 

35  39 

LID 

The  following  table  shows  the  average  expenditures  of  2,567  work- 
ingmen's families  for  each  of  the  principal  items  entering  into  the 
cost  oi  living,  and  per  cent  of  average  total  expenditure  in  1901 
(expenditure  based  on  all  families) : 


Item  of  expenditure. 

Average. 

Per  cent 
of  total 
expendi- 
ture. 

Food                   

$326.90 
99.49 

0  8.16 

6  3.98 

32.23 

8.15 

83.73 

26.03 

48.08 

6.79 

1.53 
19.44 

8.87 

5.18 

7.62 

2.39 

26.31 

8.36 

12.28 

12.44 

10.93 

20.64 

46.13 

42  54 

Rent 

12.96 

Mortgage: 

1.06 

.52 

Fuel        

4.19 

Lighting 

1.06 

Clothing: 

Husband                                     

4.39 

Wife                                                                                           -  -  . 

8.39 

Children        

6.26 

.75 

Insurance: 

Pronerty 

.20 

Life    ^                                                       .                

2.53 

Organizations: 

Labor 

.50 

Other                                                                             

.67 

.99 

Charity                                                              

.81 

Ti'iimitnrp  and  iitpnsila                                                                                     

3.42 

1.09 

A.musement8  and  vacation                                        

1.60 

Intoxicating  liauors                                                                 

L62 

L42 

2.67 

OthfiT  nurooses 

5.87 

768.64 

100.00 

•  Including  interest  paid  by  18  families. 

»Not  including  interest  paid  by  13  families,  included  in  principal. 


REPORTS   OF   THE  PRESIDENT  S  HOMES  COMMISSION. 


303 


In  Bulletin  93  of  the  Census  of  Manufactures,  1905,  published  in 
May,  1908,  we  find  some  interesting  data  of  earnings  of  wage-workers. 
The  investigation  covers  3,297,819  wage-earners,  of  which  79.4  per 
cent  were  men;  17.9  per  cent  were  women,  and  2.7  per  cent  were 
children.  The  average  weekly  earnings  of  all  classes  was  $10.06.  For 
men  16  years  and  over  it  was  $11.16 ;  for  women  $6.17,  and  for  chil- 
dren under  16  years  $3.46. 

The  greatest  number  of  men  is  reported  in  the  $12  to  $15  per  week 
group,  and  of  women  in  the  $6  to  $7  group,  while  the  greatest  num- 
ber of  children  is  reported  in  the  group  receiving  less  than  $3  a  week. 

The  important  fact  revealed  by  these  tables  is  that  out  of  the  total 
number  of  men  included  in  the  statistics  1,215,798,  or  46.5  per  cent, 
earned  $10  or  less  a  week.  It  would  be  extremely  interesting  to  learn 
how  many  of  this  group  were  married  men.  At  all  events  the  writer 
believes  that  an  explanation  for  the  large  army  of  women  and  chil- 
dren engaged  in  wage-earning  occupations  may  be  found  in  these 
figures.  It  is  simply  impossible  for  a  family  of  five  to  maintain  a 
decent  standard  of  living  on  an  income  of  $10  a  week,  and  hence  the 
wives  and  children  are  compelled  to  participate  in  the  fierce  struggle 
for  existence. 

COMPENSATION  OF  GOVERNMENT  EMPLOYEES. 

Bulletin  94  of  the  Bureau  of  the  Census,  issued  April  13, 1908,  deals 
with  statistics  of  185,874  employees,  of  which  172,053  were  males  and 
13,821  females.  The  largest  class,  viz,  43,790  persons,  or  23.6  per 
cent  of  the  total  number,  receive  from  $900  to  $1,000  per  annum ;  next 
in  numerical  importance  is  the  class  earning  less  than  $720  per 
annum,  represented  by  35,331  persons  or  19  per  cent  of  the  total; 
11.7  per  cent  of  the  total  earn  $720,  but  less  than  $840  a  year;  5.7  per 
cent  earn  between  $840  and  $900,  and  18.4  per  cent  earn  $1,000  but 
less  than  $1,200  a  year. 

The  approximate  average  compensation  is  $948.  Of  the  employees 
under  20  years  of  age,  71.2  per  cent  are  paid  at  a  rate  of  less  than 
$720  and  13.6  per  cent  at  a  rate  of  $900,  but  less  than  $1,000,  making 
a  total  in  these  two  classes  of  84.8  per  cent. 

Of  the  25,351  Government  employees  residing  in  the  District  of  Co- 
lumbia, 12,901,  or  about  one-half  of  the  total,  are  married.  The  fol- 
lowing shows  the  number  of  married  employees  in  different  salary 
groups : 


Compensation, 


Total 
employees. 


Married 
employees. 


Less  than  $720 

$720,  but  less  than  $840 

$840.  but  less  than  $900 

$900,  but  less  than  $1,000. . 
$1,000,  but  less  than  $1,200 
$1,200,  but  less  than  $1,400 
$1,400,  but  less  than  $1,600 
$1,600,  but  less  than  $1,800. 
$1,800,  but  less  than  $2,000. 
$2,000,  but  less  than  $2,500. 

$2,500,  and  over 

By  piecework 


6,501 

2,236 

602 

1,516 

2,453 

4,537 

2,469 

1,361 

1,163 

841 

617 

1.046 


2,028 

1,267 

827 

533 

1,113 

2,514 

1,552 

949 

906 

681 

504 


304  EEPOBTS  OF   THE  PBESIDENT's  HOMES  COMMISSION, 

Since  the  bulletin  contained  no  specific  data  on  the  question  of  the 
exact  earnings  of  married  men  earning  less  than  $720  a  year,  inquiries 
on  this  point  were  addressed  to  the  departments,  and  the  following 
table  shows  the  number  of  married  men  employed  in  the  respective 
departments  and  the  wage  groups :  « 


Department  of  Agriculture 

Treasury  Department 

Department  of  the  Interior 

Department  of  Commerce  and  Labor. 

War  Department 

Navy  Department 

Postmaster-General , 

Department  of  the  Interior 

Department  of  State 

Interstate  Commerce  Commission 


Salary 
«600  to  8700. 


90 
188 
205 

42 
122 

54 

51 


13 


771 


Salary 
$500  to  $600. 


47 

115 

19 

3 


195 


Salary 
below 
«500. 


67 


From  this  table  it  appears  that  there  are  1,033  married  men  in  the 
Government  employ  in  this  city  earning  less  than  $660  a  year,  262  of 
whom  receive  $600  a  year  or  less. 

In  addition  to  the  foregoing,  according  to  information  kindly  fur- 
nished by  Commisisoner  West,  and  the  disbursing  officer,  Mr.  Wilson, 
there  are  515  married  employees  in  the  District  government  earning 
less  than  $500  a  year;  450  married  employees  earning  between  $500 
and  $600,  and  251  married  employees  earning  between  $600  and  $720 
a  year. 

A  general  survey  of  the  situation  justifies  the  conclusion  that  the 
cost  of  living  has  lar  outstripped  the  present  rates  of  wages  of  men 
earning  less  than  $720  a  year  and  of  salaried  employees  m  general. 
This  can  only  be  remedied  by  an  increase  in  wages  or  a  decided  de- 
crease in  the  cost  of  the  necessities  of  life.  Since  the  latter  is  beyond 
the  general  control  of  wage-earners,  except  in  so  far  as  increased 
wages  affect  the  cost  of  the  products  of  labor,  an  increase  in  earnings 
amounting  to  at  least  25  per  cent  appears  urgently  called  for. 

No  effort  should  be  spared  to  improve  the  standards  of  living  of 
poorly  paid  wage-workers,  especially  of  married  men  earning  less 
than  $2  a  day.  Justice  likewise  demands  an  increase  of  25  per  cent 
in  the  pay  of  salaried  employees,  especially  where  no  such  increase 
has  been  made  during  the  past  ten  years,  in  order  to  compensate  for 
the  increased  cost  of  living. 

It  has  come  to  the  knowledge  of  the  committee  that  a  large  number 
of  employees  in  the  navy-yard  who  have  purchased  homes  and  own 
an  equity  in  the  property,  are  likely  to  suffer  financial  losses  should 
the  intentions  of  the  department  to  have  the  work  done  elsewhere  and 
reduce  the  number  of  employees  here  be  carried  out.  This  should  be 
avoided,  if  possible,  on  account  of  the  evident  hardships  involved. 
It  is  believed  that  the  best  interests  of  the  service  and  of  wage- 
v7orkers  would  be  subserved  if  a  reasonable  assurance  of  permanent 
employment  could  be  given. 

•This  does  not  include  employees  in  the  Government  Printing  Office  and 
Navy-Yard. 


KEPORTS   OF   THE  PRESIDENT 's  HOMES   COMMISSION.  305 

In  the  sociological  study  of  our  least  resourceful  neighbors  we  find 
ample  food  for  reflection.  We  encounter  families  who,  although  the 
husband  earns  $2.50  a  day  when  he  works,  are  on  the  borderland  of 
dependency,  because  he  takes  three  drinks  of  whisky  a  day  at  5  cents 
each  and  consumes  25  cents'  worth  over  Sunday,  which  means  not 
only  an  expenditure  of  $59.80  a  year  for  drink,  but  also  considerable 
loss  of  work  on  account  of  preventable  illness. 

While  the  conditions  as  a  whole  in  our  family  groups  whose  income 
is  less  than  $700  a  year  indicate  a  fierce  struggle  for  existence,  some 
splendid  examples  of  neat  and  healthful  homes,  of  thrift  and  happi- 
ness, could  be  cited  for  the  emulation  of  less  competent  neighbors. 
The  explanation  is  to  be  found  in  the  fact  that  the  parents  lead  a 
strictly  temperate  life,  the  mother  is  a  good  home  maker  and  anxious 
to  better  the  future  of  her  children,  and  her  spirit  of  economy,  thrift, 
and  ambition  animates  every  member  of  the  household.  These  prin- 
ciples should  be  inculcated  into  the  minds  of  ever}^  child.  An  at- 
tempt has  been  made  in  several  cities  to  introduce  the  Provident 
Stamp  Saving  System  into  the  public  schools.  There  can  be  no  ques- 
tion that  all  such  efforts,  and  the  establishment  of  postal  savings 
banks,  would  stimulate  provident  habits.  If  it  is  possible  for  the 
agents  and  friendly  visitors  of  the  Associated  Charities  to  collect  over 
$12,000  a  year  in  this  city  from  the  least  resourceful  people  as  stamp 
savings  deposits  for  emergency  purposes,  there  is  no  good  reason  why 
the  great  army  of  better  paid  wage-earners,  including  salaried  em- 
ployees, should  not  cultivate  similar  habits  of  thrift  and  economy. 
While  it  is  true  that  a  goodly  number  have  established  their  homes 
and  are  gradually  paying  for  them,  it  is  equally  true  that  in  these 
days  of  inordinate  desire  for  pleasure,  dress  and  social  rivalry,  a  very 
discreditable  number  live  wholly  beyond  their  income  and  sooner  or 
later  fall  into  the  hands  of  the  "  loan  and  salary  sharks." 

Chapter  XIV. 

SUPPRESSION  OF  USURY  IN  THE  DISTRICT  OF  COLUMBIA. 

[By  Geo.  M.  Kobeb,  M.  D.] 

INTRODUCTION. 

In  view  of  the  great  number  of  cases  of  exorbitant  rates  of  interest 
charged  by  salary  and  loan  sharks  which  have  come  under  the  notice 
of  the  writer  in  connection  with  the  Associated  Charities,  and  also 
in  our  sociological  study  of  families,  it  was  deemed  desirable  to  se- 
cure additional  information  on  the  subject  with  a  view  of  formulat- 
ing suitable  recommendations  for  the  suppression  of  the  evil.  Mr. 
Charles  F.  Weller,  of  the  Associated  Charities,  and  Mr.  George  S. 
Wilson,  of  the  Board  of  Charities,  referred  in  their  discussion  of  the 
subject  to  the  efforts  of  the  "  Society  for  Savings  "  to  bring  about  a 
more  tolerable  state  of  affairs.  In  a  number  of  interviews  with  offi- 
cers of  that  society  it  was  learned  that  they  had  entered  the  field,  for 
which  there  was  an  urgent  need,  with  the  hope  of  ameliorating  the 
condition  of  a  large  number  of  government  employees  by  offering  a 
S.  Doc.  644,  60-2 ^21 


306  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

better  service  at  a  reasonable  price.  The  society  found  itself  handi- 
capped, however,  by  engaging  in  a  business  which  can  not  be  carried 
on  at  the  present  legal  rate  of  interest  (6  per  cent),  and  also  because 
good  citizens  do  not  care  to  invest  funds  which  are  loaned  in  violation 
of  the  law.  The  officers,  anxious  to  extend  the  usefulness  of  the 
society,  and  at  the  same  time  to  conduct  a  strictly  legitimate  business, 
have  made  a  careful  study  of  the  remedial  legislation  in  other  States, 
with  a  view  of  promoting  similar  legislation  in  the  District  of 
Columbia. 

The  principles  embodied  in  modern  legislation  of  this  class  are 
based  upon  the  theory  that  money-lending  concerns  are  a  necessity; 
that  small  loans  of  this  character  can  not  be  made  at  a  less  rate  of 
interest  than  2  to  3  per  cent  a  month  during  the  first  year  of  the 
loan ;  that  legalization  of  such  rates  will  attract  the  capital  of  reputa- 
ble citizens  and  stimulate  wholesome  competition,  which  will  ulti- 
mately result  in  the  reduction  of  the  interest  rate  to  about  1  per  cent 
per  month.  From  the  experience  of  the  Provident  Loan  Society,  of 
New  York,  conceived  and  managed  as  a  true  business  philanthropy, 
it  is  apparent  that  a  business  in  small  loans  can  not  be  now  conducted, 
except  as  a  purely  charitable  proposition,  at  less  than  1  per  cent 
per  month. 

This  subject  is  one  of  great  importance  to  a  very  large  number  of 
officials  and  employees  of  the  government  and  of  wage-earners  in 
general.  The  writer  therefore  requested  Mr.  J.  T.  Exnicios,  the 
manager  and  treasurer  of  the  Society  for  Savings,  to  present  the 
result  of  his  study  of  existing  conditions  in  this  city,  and  of  the  most 
enlightened  legislation  which  has  been  enacted  in  Massachusetts,  New 
York,  and  elsewhere  to  safeguard  this  unfortunate  class  of  borrow- 
ers against  the  vicious  practices  employed  by  unscrupulous  concerns. 
This  he  has  done  in  a  very  satisfactory  and  comprehensive  manner. 
From  a  careful  study  of  existing  evils  the  writer  feels  convinced 
that  the  bill  framed  by  the  commissioners,  and  known  as  H.  R.  11772 
and  S.  2296  will,  if  enacted  with  a  few  minor  amendments,  have  a 
most  salutary  effect.  The  amendments  suggested  by  Mr.  Exnicios 
are  in  line  with  legislation  in  other  States.  One  of  these  is  the  reduc- 
tion of  a  license  tax  from  $1,000  to  $100  per  annum.  The  tax  in 
Massachusetts  is  only  $50  a  year,  but  the  law  requires  that  all  exami- 
nations of  the  affairs  of  such  concerns  made  by  the  bank  commis- 
sioners of  the  State  shall  be  at  their  expense.  New  York,  Rhode 
Island,  and  Maryland  require  no  license  tax. 

It  is  very  evident  that  all  such  charges  are  placed  by  indirection  on 
the  borrower.  For  this  reason,  no  doubt,  the  recorders'  fee  on  chattle 
mortgages  in  Massachusetts  is  only  75  cents,  and  no  notarial  certificate 
is  required  on  this  class  of  mortgages,  while  the  charges  in  this  juris- 
diction amount  to  $2.85,  which  greatly  increases  the  cost  of  small 
loans. 

The  provisions  of  the  bill,  on  the  whole,  are  excellent.  Sections  4 
and  5  are  especially  commendable,  as  tjiey  require  a  register  to  be 
kept  of  all  loans  and  transactions,  subject  to  official  inspection.  The 
execution  of  such  a  law,  in  order  to  safeguard  against  abuses,  re- 
quires careful  official  supervision,  such  as  contemplated  by  the  recom- 
mendations to  the  President,  April  29,  1907,  of  Mr.  James  B.  Reyn- 
olds, in  the  creation  of  a  bureau  of  labor. 


BEPOETS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  307 

THE  USURY  EVIL  IN  THE  CITY  OF  WASHINGTON. 
[By  J.  T.  ExNicios.] 

I.   THE  MONEY  BOBBOWEE. 

In  the  city  of  Washington  there  is  a  very  large  number  of  per- 
sons who  are  unable  to  secure  loans  from  banks,  trust  companies, 
or  real- estate  brokers,  because  having  nothing  in  the  form  of  assets 
except  their  labor  or  earning  capacity  to  offer  as  security,  or  possibly 
household  effects,  and  perhaps  jewelry.  These  people  might  be  di- 
vided into  three  classes  or  groups : 

First,  the  government  clerks  and  employees,  who  can  offer  nothing 
as  security  for  money  but  their  individual  notes  secured  by  the  in- 
dorsement of  their  fellow-clerks. 

Second,  that  class  of  persons  who,  for  various  reasons,  do  not  care 
to  have  their  needs  made  known  to  their  friends  on  account  of  their 
standing  in  the  community,  and  offer  as  security  for  money  obtained 
their  jewelry  or  other  personal  effects,  and  who,  while  possessing 
homes  and  furniture,  hesitate  to  give  a  chattel  mortgage  on  their 
household  furniture  because  of  the  publicity  attendant  upon  the  re- 
cording of  such  mortgages. 

Third,  that  very  large  class  of  people  who,  not  having  steady  em- 
ployment or  regular  sources  of  income,  and  who,  usually  on  account 
of  the  small  wages  earned,  and  having  large  families  depending  upon 
them,  are  unable  to  lay  aside  any  savings  to  meet  emergencies,  are 
compelled  to  mortgage  their  household  effects;  and  as  such  people 
nearly  always  need  money,  and  emergencies  arise  when  they  must 
have  it  quickly,  they  instinctively  turn  to  the  only  source  open  to 
them,  the  loan  shark. 

The  money  lender  exists  here  because  he  is  needed  and  renders 
an  indispensable  service  to  those  whose  living  depends  on  the  work- 
shop, the  office,  the  city,  or  the  National  Government,  where  men 
and  women  are  earning  salaries  and  wages.  Salary  earners  are  a 
never-failing  source  of  income  and  support  to  him.  He  is  par- 
ticularly active  among  clerks  in  every  department  and  bureau  of  our 
Government;  among  school  teachers,  firemen,  policemen,  and  other 
city  employees,  the  newspaj)er  office  and  the  railroad  office,  but  more 
especially  among  the  laboring  class,  where  he  not  only  trades  and 
fattens  on  their  necessities  but  on  their  ignorance. 

The  cruel  part  of  the  whole  system  is  the  pettiness  of  the  loans 
made  to  the  laboring  class.  The  loan  seldom  exceeds  $25,  and  the 
need  arises  from  sickness  or  trouble  in  the  workman's  family.  His 
pay  is  small,  just  enough  to  live  on ;  he  may  be  going  through  that 
period  in  the  life  of  a  family  when  children  are  born,  or  when  they 
are  being  educated,  the  expenses  come  closer  to  the  danger  line.  Wife 
or  child  may  fall  ill  and  an  extra  outlay  has  to  be  met;  other  ex- 
penses, such  as  rent  or  grocery  accounts,  get  behind,  creditors  begin 
to  press,  the  man  is  worried  and  miserable,  and  seeks  relief  from  the 
only  source  at  his  command,  the  loan  shark,  whose  advertisement 
offers  money  an  easy  payments  and  long  time.  He  calls  on  the  ad- 
vertiser, anxious,  flustered,  disheartened;  is  received  cordially,  and 
assured  suavely  that  such  difficulties  are  common  and  of  daily  occur- 
rence ;  told  to  call  again ;  his  record  is  investigated  meanwhile  and 


308  BEPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

his  household  furniture  appraised.  On  his  return  he  secures  the 
small  sum  needed,  signs  some  papers  "  as  a  matter  of  form,"  and  is 
tied  hand  and  foot  for  perhaps  years.  Very  few  attempt  to  evade 
these  obligations,  and  as  a  consequence  the  loan  sharks  have  very  few 
occasions  for  bringing  suit  to  enforce  payment  of  these  loans  to  the 
last  penny.  He  indulges  in  threats,  but  rarely  executes  them,  for  his 
great  dread  is  publicity. 

n.      THE   MONEY  LENDERS   AND   THEIE    METHODS. 

There  are  many  money  lenders  and  money-lending  concerns  in 
Washington  (about  72),  with  an  invested  capital  of  approximately 
a  million  dollars,  loaning  money  at  exorbitant  rates  of  interest  upon 
mortgages  of  furniture  and  household  effects,  other  personal  prop- 
erty, and  indorsed  notes.  The  rate  of  interest  charged  varies  very 
much ;  often  the  rate  is  as  low  as  10  per  cent  per  month ;  sometimes 
as  high  as  25  per  cent,  and  occasionally  even  a  higher  rate  of  interest 
is  exacted.  The  following  are  a  few  of  the  many  advertisements 
which  can  be  found  in  our  daily  papers : 

Potomac  Guarantee  Loan  Gompa/ny,  925  F  street  N.  W, 

$10  for  one  month  costs  $0.60  (or  72  per  cent  per  annum). 
$20  for  one  month  costs  $1.05  (or  63  per  cent  per  annum). 
$30  for  one  month  costs  $1.45  (or  58  per  cent  per  annum). 
We  also  make  a  small  charge  for  appraising  property,  etc. 

Union  Loan  and  Trust  Company,  810  F  street  NW. 

$10  for  one  month  costs  $1.50  (or  180  per  cent  per  annum). 
$20  for  one  month  costs  $2.25  (or  135  per  cent  per  annum). 
$25  for  one  month  costs  $2.50  (or  120  per  cent  per  annum). 

Mutual  Loan  and  Trust  Company,  913  G  street  NW. 

35  cents  a  week  pays  interest  and  principal  on  a  $10  loan. 
50  cents  a  week  pays  interest  and  principal  on  a  $15  loan. 
75  cents  a  week  pays  interest  and  principal  on  a  $20  loan. 
90  cents  a  week  pays  interest  and  principal  on  a  $25  loan. 
$1.50  a  week  pays  interest  and  principal  on  a  $50  loan. 
$2.75  a  week  pays  interest  and  principal  on  a  $100  loan. 

Now,  these  sums  are  paid  by  the  borrower  for  a  period  of  fifty-two 
weeks,  hence  the  cost  of  $10  is  $8.20,  or  161  per  cent  per  annum ;  $15 
is  $11,  or  140  per  cent  per  annum;  $20  is  $19,  or  180  per  cent  per 
annum;  $25  is  $21.80,  or  171  per  cent  per  annum;  $50  is  $28,  or  109 
per  cent  per  annum ;  $100  is  $43,  or  83  per  cent  per  annum. 

The  Surety  Loan  Company,  Ninth  and  F  streets  NW.,  whose 
charges  are  on  $10  for  one  month,  $1 ;  on  $15  for  one  month,  $1.50 ; 
on  $20  for  one  month,  $2.  That  is  10  per  cent  per  month,  or  120  per 
cent  per  annum.  "  No  more,  no  less,"  to  quote  their  advertisement. 
Added  to  these  various  rates  are  the  charges  for  notary  fees,  record- 
ing mortgages,  etc.,  running  from  $3  to  $10. 

Borrowers  in  many  instances  pay  this  heavy  interest  for  months, 
and  even  for  years,  without  decreasing  the  amount  of  the  original 
debt,  and  often  lose  the  property  mortgaged  by  them,  even  when  they 
have  paid  the  amount  of  the  principal  borrowed  with  lawful  interest, 
for  under  such  rates  a  borrower  can  seldom  pay  up  the  principal  of 


REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  309 

his  loan,  but  goes  on,  year  after  year,  paying  this  heavy  interest, 
often  in  the  end  to  have  all  he  possessed  taken  from  him  when  the 
lender  demands  his  principal. 

Some  of  these  concerns  operate  two  or  three  companies,  located 
at  different  addresses  and  under  different  names,  and  incidentally 
suggest  to  the  borrower  that,  being  unable  to  loan  more  than  a  part 
of  the  sum  desired,  they  might  succeed  in  securing  the  additional 

amount  by  applying  to ,  furnishing  the  address  of  one  of  the 

other  offices,  when,  after  paying  over  again  the  usual  charges  for 
recording,  notary  fee,  appraisement,  etc.,  the  borrower  receives  the 
amount  necessary  to  make  up  the  original  sum  asked  for.  We  have 
in  mind  a  particular  case  where  the  sum  required  was  $30  on  fur- 
niture. After  going  to  three  of  these  (allied)  concerns  the  borrower 
secured  the  amount,  $10  at  each  place  and  paid  the  regular  fees  at 
each  place. 

At  a  hearing  before  the  subcommittee  on  judiciary  of  the  Com- 
mittee on  the  District  of  Columbia,  United  States  Senate,  May  6, 
1908,  on  various  bills  introduced  for  the  suppression  of  usury  in 
the  District  of  Columbia  the  testimony  of  Senator  Gallinger,  Com- 
missioner Macfarland,  and  Mrs.  Charlotte  Everett  Hopkins  all  point 
to  the  grossest  forms  of  abuses  and  exorbitant  rates  of  interest  which, 
in  the  opinion  of  Senator  Gallinger,  "  no  community  ought  to  permit 
anyone  to  exact  from  poor  people." 

All  the  cases  cited  differ  only  in  degree,  not  in  kind,  and  how  many 
of  them  there  are  in  any  one  year  no  one  can  ever  tell,  but  there  are 
thousands  of  loans  made  annually,  and  as  the  profits  must  be  enor- 
mous the  suffering  entailed  must  be  in  due  proportion.  These  con- 
ditions have  continued  for  a  number  of  years  and  naturally  have 
grown  worse,  and  though  staggering  and  almost  incredible  they  are 
borne  out  by  facts  on  record. 

The  foregoing  statement  also  covers  fully  the  abuses  that  were  wont 
to  exist  in  the  States  of  New  York,  Massachusetts,  Rhode  Island,  and 
Maryland  until  public  opinion  through  the  legislatures  of  these 
States  enacted  laws  which  put  a  stop  to  the  evil  practice. 

III.    MEANS   OF   PBEVENTION    TRIED   IN    WASHINGTON    SINCE   1905. 

In  January,  1905,  there  was  incorporated  in  this  city  the  Society 
for  Savings  of  Washington,  modeled  after  similar  concerns  in  a  num- 
ber of  the  States,  for  the  purpose,  among  others,  of  lending  money 
to  deserving  persons  on  indorsed  notes.  It  was  never  for  a  moment 
contemplated  that  the  new  venture  should  be  in  any  sense  a  charity ; 
in  fact,  it  was  realized  that  to  lend  money  as  a  work  of  charity 
would  fail  to  reach  the  very  class  of  persons  whom  it  was  desired 
to  afford  a  means  of  relieving  a  temporary  embarrassment,  namely, 
persons  who,  while  not  able  to  obtain  loans  from  banks,  trust  com- 
panies, or  real  estate  brokers,  are  able  and  willing  to  pay  reasonably 
for  the  accommodation. 

The  capital  stock  was  fixed  at  $50,000,  most  of  which  is  now  paid 
in.  In  the  beginning,  after  considerable  effort,  a  sum  of  about  $7,500 
was  raised  and  operations  were  started.  The  loans  made  were  neces- 
sarily small,  averaging  $25,  and  never  exceeding  $50,  to  any  one  per- 
son upon  indorsed  notes  and  confined  almost  exclusively  to  clerks  in 
the  various  Government  departments,  and  at  a  rate  of  interest  of  3 


310  REPORTS  OP  THE  PRESIDENT'S  HOMES  COMMISSION. 

per  cent  per  month.  After  the  first  year,  and  upon  increasing  the 
capital  employed,  the  rate  was  reduced  to  2J  per  cent  per  month,  and 
is  now  2  per  cent  per  month,  with  a  small  charge  according  to  the 
amount  loaned,  in  some  cases  25  cents,  as  upon  a  $25  loan,  which  costs 
75  cents  for  one  month,  but  never  exceeding  $3  in  any  one  year,  and 
this  latter  sum  is  charged  only  when  loans  are  made  on  household 
goods  (including  charges  of  every  character,  among  which  is  $2.35, 
the  actual  fee  for  court  recording,  and  50  cents  for  notary  fee,  or 
$2.85),  which  feature  of  the  business  was  adopted  about  the  beginning 
of  this  year.  In  some  very  deserving  cases  a  charge  of  IJ  per  cent 
per  month  has  been  made,  and  only  one-half  per  cent  a  month  in  one 
case,  that  of  a  young  man,  a  messenger  in  one  of  the  departments, 
who  became  deeply  involved  with  a  number  of  money  lenders  to  the 
extent  of  about  $500.     *     *     * 

Much  good,  it  is  believed,  has  been  done  by  this  society,  and  a  great 
deal  more  could  be  done  were  it  possible  to  secure  the  funds  needed ; 
but  its  business  being  what  may  be  termed  "  outlawed,"  the  directors 
have  labored  under  a  handicap  that  is  almost  disheartening. 

Small  sums  of  money  can  not  be  loaned  at  the  legal  rate  of  interest 
(6  per  cent),  pay  operating  expenses,  no  matter  how  economically 
the  business  is  conducted,  stand  the  inevitable  losses  through  uncol- 
lectible notes,  and  pay  a  fair  dividend  on  the  capital  invested.  This 
has  been  demonstrated  time  and  again  in  every  State  of  the  Union 
and  in  foreign  countries  as  well.  If  there  could  be  any  doubt  of  the 
correctness  of  this  statement,  legislation  which  has  been  enacted  in 
many  of  the  States  will  prove  its  truth.  This  legislation  will  be  more 
particularly  referred  to  further  on. 

IV.   BEMEDY  PROPOSED. 

The  most  effective  way  to  get  rid  of  the  loan  and  salary  shark  is  to 
meet  him  on  his  own  ground.  Legislation  will  not  kill  him.  In  try- 
ing to  exterminate  him  legislation  is  apt  to  abolish  the  service  and 
furnish  nothing  to  replace  it.  ^      ^ 

The  logical  way  to  get  rid  of  him  is  to  supply  a  better  service  at 
reasonable  rates.  Along  this  line  some  very  effective  work  is  now 
being  done  under  protection  of  the  law  in  other  cities  and  could  be 
done  here  by  the  enactment  of  a  suitable  bill,  which  has  been  drafted 
by  the  District  Commissioners  and  is  known  as  S.  2296  and  H.  R. 
11772.  Under  its  provisions  the  business  will  become  legalized,  the 
stigma  which  now  attaches  to  those  carrying  on  a  business  not  strictly 
lawful  would  be  wiped  out,  and  a  better  class  of  our  citizens  would 
engage  therein,  more  capital  would  be  attracted,  and  there  would 
be  more  competition,  with  the  consequent  lowering  of  the  interest 
charged  and  a  resulting  benefit  to  the  borrower  and  the  community. 

A  BILL  To  regulate  the  business  of  loaning  money  on  security  of  any  kind  by  persons,, 
firms,  and  corporations  other  than  national  banks,  savings  banks,  and  trust  companies 
and  real-estate  brokers  in  the  District  of  Columbia. 

Be  it  enacted  hy  the  Senate  and  House  of  Representatives  of  the  United  States 
of  America  in  Congress  assemtled.  That  hereafter  It  shall  be  unlawful  and 
Illegal  to  engage  in  the  business  of  loaning  money  on  any  security  of  any  kind, 
direct  or  collateral,  tangible  or  intangible,  without  procuring  license;  and  all 
persons,  firms,  joint-stock  companies,  voluntary  associations,  and  corporations 
engaged  In  said  business  shall  pay  a  license  tax  of  one  thousand  dollars  per 
annum  to  the  District  of  Columbia. 


BEPORTS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  311 

Sec.  2.  That  applications  for  licenses  to  conduct  such  business  must  be  made 
In  writing  to  the  Commissioners  of  the  District  of  Columbia,  and  shall  contain 
the  full  names  of  applicants,  if  natural  persons,  and  the  full  names  of  the 
officers  and  directors,  by  whatever  name  known,  of  corporations,  companies, 
and  associations,  the  addresses  of  all  persons  named  therein  and  the  place 
where  such  business  is  to  be  conducted,  and  such  other  information  as  the 
said  commissioners  may  require.  Every  license  granted  shall  date  from  the 
first  of  the  month  in  which  it  is  issued  and  expire  on  the  thirty-first  day  of  the 
following  October.  Every  application  shall  be  filed  not  less  than  one  week 
prior  to  the  granting  of  such  license,  and  notice  of  the  filing  of  such  application 
shall  be  posted  in  the  office  of  the  assessor  of  the  said  District.  Protests  may 
be  made  by  any  person  to  the  issuing  of  such  license,  and  when  such  protests 
are  filed  with  the  said  commissioners  the  latter  shall  give  public  notice  of  and 
hold  a  public  hearing  upon  such  protests  before  issuing  such  license.  The  said 
commissioners  shall  have  power  to  reject  any  application  for  license  for  failure 
to  observe  this  act,  and  for  such  failure  to  suspend  or  revoke  any  such  license 
for  cause  shown,  after  notice  and  hearing. 

Sec.  3.  That  each  application  shall  be  accompanied  by  a  bond  to  the  District 
of  Columbia  in  the  penal  sum  of  five  thousand  dollars,  with  two  or  more  suffi- 
cient sureties,  and  conditioned  that  the  obligor  will  not  violate  any  law  relating 
to  such  business.  The  execution  of  any  such  bond  by  a  fidelity  or  surety 
company  authorized  by  the  laws  of  the  United  States  to  transact  business 
therein  shall  be  equivalent  to  the  execution  thereof  by  two  sureties,  and  such 
company,  if  excepted  to,  shall  justify  in  the  manner  required  by  law  of  fidelity 
and  surety  companies.  If  any  person  shall  be  aggrieved  by  the  misconduct  of 
any  such  licensed  person,  firm,  corporation,  company,  or  association,  and  shall 
recover  a  judgment  therefor,  such  person  may,  after  a  return  unsatisfied  either 
in  whole  or  in  any  part  of  any  execution  issued  upon  such  judgment,  maintain 
an  action  in  his  own  name  upon  such  bond  herein  required  in  any  court  having 
jurisdiction  of  the  amount  claimed.  The  Commissioners  of  the  District  of 
Columbia  shall  furnish  to  anyone  applying  therefor  a  certified  copy  of  any 
such  bond  filed  with  them  upon  the  payment  of  a  fee  of  twenty-five  cents,  and 
such  certified  copy  shall  be  prima  facie  evidence  in  any  court  that  such  bond 
was  duly  executed  and  delivered  by  the  person*  firm,  corporation,  company,  or 
.  association  whose  names  appear  thereon. 

Sec.  4.  That  every  person,  firm,  corporation,  company,  or  association  conduct- 
ing such  business  shall  keep  a  register,  approved  by  said  commissioners,  show- 
ing, in  English,  the  amount  of  money  loaned,  the  date  when  loaned  and  when 
due,  the  person  to  whom  loaned,  the  property  or  thing  named  as  security  for 
the  loan,  where  the  same  is  located  and  in  whose  possession,  the  amount  of 
interest,  all  fees,  commissions,  and  renewals  charged,  under  whatever  name. 
Such  register  shall  be  open  for  inspection  to  the  said  commissioners,  their 
officers  and  agents,  on  every  day,  except  Sundays  and  legal  holidays,  between 
the  hours  of  nine  o'clock  in  the  forenoon  and  five  o'clock  in  the  afternoon. 

Sec.  5.  That  no  such  person,  firm,  corporation,  company,  or  association 
shall  charge  or  receive  a  greater  rate  of  interest  or  discount  upon  any  loan 
made  by  him  or  it  than  two  per  centum  per  month  and  a  sum  not  exceeding 
three  dollars  for  the  first  examination  of  the  property  to  be  mortgaged,  or  the  in- 
vestigation of  the  credit  or  responsibility  of  indorsers  or  sureties  when  an 
indorsed  note  is  taken  as  security,  and  for  drawing  the  necessary  papers, 
which  charge  shall  include  all  services  of  every  character  in  connection  with 
the  loan,  except  upon  the  foreclosure  of  the  security,  and  no  additional  sums, 
either  in  the  way  of  bonus  or  otherwise,  shall  be  required  or  exacted  of  bor- 
rowers; nor  shall  it  be  lawful  to  divide  or  split  up  loans  under  any  pretext 
whatsoever  for  the  purpose  of  requiring  or  exacting  any  other  or  greater 
charge  than  herein  prescribed.  The  foregoing  interest  and  charge  may  be 
deducted  from  the  principal  of  the  loan  when  the  same  is  made.  No  such 
loan  greater  than  five  hundred  dollars  shall  be  made  to  any  one  person. 

Sec.  6.  That  the  enforcement  of  this  act  shall  be  intrusted  to  the  Commis- 
sioners of  the  District  of  Columbia.  Complaints  against  any  licenses  or  appli- 
cant shall  be  made  in  writing  to  the  said  commissioners,  and  reasonable  notice 
thereof,  not  less  than  one  day,  shall  be  given  to  said  licensee  or  applicant  by 
serving  upon  him  a  concise  statement  of  the  facts  constituting  the  complaint, 
and  a  hearing  shall  be  had  before  the  said  commissioners  within  one  week 
from  the  date  of  the  filing  of  the  complaint,  and  no  adjournment  shall  be  taken 
for  longer  than  one  week.  A  daily  calendar  shall  be  kept  of  all  hearings  by 
the  said  commissioners,  which  shall  be  posted  in  a  conspicuous  place  in  their 


312  EEPOBTS  OP  THE  PEESIDENt's  HOMES  COMMISSION. 

public  office  for  at  least  one  day  before  the  date  of  such  hearings.  The  said 
commissioners  shall  render  their  decision  within  eight  days  from  the  time  the 
matter  is  finally  submitted  to  them.  Said  commissioners  shall  keep  a  record 
of  all  such  complaints  and  hearings,  and  may  refuse  to  issue  and  shall  revoke 
any  license  for  any  good  cause  shown,  within  the  meaning  and  purpose  of  this 
act;  and  when  it  is  shown  to  their  satisfaction  that  any  license  or  applicant 
under  this  act,  either  before  or  after  conviction,  is  guilty  of  any  conduct  in 
violation  of  this  law,  it  shall  be  the  duty  of  the  said  commissioners  to  revoke 
or  reject  the  license  of  such  licensee  or  applicant,  but  notice  of  the  charges 
preferred  shall  be  presented  and  reasonable  opportunity  shall  be  given  said 
licensee  or  applicant  to  be  heard  in  his  defense.  Whenever  for  any  cause  such 
license  is  revoked,  said  commissioners  shall  not  issue  another  license  to  said 
licensee  until  the  expiration  of  at  least  six  months  from  the  date  of  revocation 
of  such  license. 

Sec.  7.  That  any  violation  of  this  act  shall  be  punished  by  a  fine  of  not  less 
than  five  dollars  and  not  greater  than  two  hundred  dollars.  The  said  commis- 
sioners shall  cause  the  corporation  counsel  to  institute  criminal  proceedings 
for  the  enforcement  of  this  act  before  any  court  of  competent  jurisdiction. 

Sec.  8.  That  nothing  contained  in  this  act  shall  be  held  to  apply  to  the  legiti- 
mate business  of  institutions  which  are  members  of  the  Bankers'  Association 
of  the  District  of  CJolumbia,  building  and  loan  associations,  or  to  the  business 
of  pawnbrokers  or  real-estate  brokers,  as  defined  in  the  act  of  Congress  of  July 
first,  nineteen  hundred  and  two. 

Sec.  9.  That  the  Commissioners  of  the  District  of  Columbia  are  hereby  author- 
ized and  empowered  to  make  all  rules  and  regulations  necessary  in  their  judg- 
ment for  the  conduct  of  the  said  business  and  the  enforcement  of  this  act  in 
addition  hereto  and  not  inconsistent  herewith. 

Sec.  10.  That  all  acts  and  parts  of  acts  inconsistent  herewith  are  hereby 
repealed. 

Sec.  11.  That  this  act  shall  take  effect  from  and  after  its  passage. 

V.  amendments  peoposed  and  approval  of  the  bill. 

Be  it  enacted  ^y  the  Senate  and  House  of  Representatives  of  the  United  States 
of  America  iti  Congress  assembled,  That  hereafter  it  shall  be  unlawful  and 
illegal  to  engage  in  the  business  of  lending  money  on  any  security  of  any  kind, 
direct  or  collateral,  tangible  or  intangible,  without  procuring  license,  and  all 
persons,  firms,  joint-stock  companies,  voluntary  associations,  and  corporations 
engaged  in  said  business  shall  pay  a  license  tax  of  one  thousand  dollars  per 
annum  to  the  District  of  Columbia. 

First,  amend  this  section  by  inserting  after  the  word  "  money,"  in 
line  4,  the  words  "  upon  which  a  rate  of  interest  greater  than  6  per 
cent  per  annum  is  charged,"  so  that  it  shall  read :  "  The  business  of 
loaning  money,  upon  which  a  rate  of  interest  greater  than  6  per  cent 
per  annum  is  charged,"  etc. 

Second,  substitute  "  one  hundred  "  for  "  one  thousand,"  in  line  8,  so 
that  it  shall  read :  "  Business  shall  pay  a  license  tax  of  one  hundred 
dollars  per,"  etc. 

Reasons, — All  States  which  now  have  laws  governing  the  loaning 
of  money  specifically  state  in  the  acts  that  all  persons,  firms,  etc., 
loaning  money  at  more  than  the  legal  rate  of  interest,  etc.,  which 
shows  that  the  provision  has  been  carefully  looked  into  and  deemed 
necessary.  It  might  be  said  in  this  connection  that  Senator  Johnston 
and  Hon.  J.  M.  Thurston  stated  they  "  thought  it  might  be  a  wise 
provision,"  at  the  hearing  before  the  subcommittee  on  judiciary  of  the 
Committee  on  the  District  of  Columbia,  May  6,  1908,  at  which  the 
former  was  present  as  a  member  of  said  committee,  and  the  latter 
as  attorney  representing  some  money  lenders. 

As  to  the  amount  of  license  tax,  the  State  of  Massachusetts  exacts 
a  tax  of  only  $50  per  year,  but  requires  that  all  examinations  of  the 
affairs  of  these  concerns  made  by  the  bank  commissioners  of  the  State 


BEPOBTS  OP   THE  PBESIDENt's  HOMES  COMMISSION.  313 

shall  be  at  their  expense.  The  State  of  New  York  does  not  require  a 
license,  nor  does  the  State  of  Ehode  Island,  nor  the  State  of  Maryland. 

That  $1,000  per  annum  should  not  be  exacted  as  a  license  charge 
or  tax  seems  to  require  no  argument.  It  would  be  wringing  from  the 
lenders  a  sum  which  is  much  too  large,  and  would  hold  an  inducement 
for  some  of  them  to  place  this  charge  by  indirection  on  the  borrower. 
Further,  Commissioner  West  states:  "Though  this  tax  of  $1,000  was 
inserted,  they  were  not  insisting  upon  that  amount,  and  it  might  well 
be  reduced."    (Senate  hearing.  May  6,  1908,  p.  21.) 

Section  2:  This  section  is  in  line  with  the  practice  and  laws  in 
force  in  States  hereinbefore  mentioned. 

Section  3 :  Same  reason  as  applied  to  section  2. 

Section  6 :  Same  as  section  2. 

Sections  9,  10,  and  11 :  Same  as  section  2. 

Sec.  4.  That  every  person,  firm,  corporation,  company,  or  association  con- 
ducting such  business  shall  keep  a  register  approved  by  said  commissioners, 
showing  in  English  the  amount  of  money  loaned,  the  date  when  loaned,  and 
when  due,  the  person  to  whom  loaned,  the  property  or  thing  named  as  security 
for  the  loan,  where  the  same  is  located,  and  in  whose  possession,  the  amount 
of  interest,  all  fees,  commissions,  and  renewals  charged,  under  whatever  name. 
Such  register  shall  be  open  for  inspection  to  the  said  commissioners,  their 
officers  and  agents,  on  every  day,  except  Sunday  and  legal  holidays,  between 
the  hours  of  nine  o'clock  in  the  forenoon  and  five  o'clock  in  the  afternoon. 

The  only  way  to  regulate  this  business  is  through  publicity,  for 
laws,  no  matter  how  drastic  their  provisions,  can  and  will  be  evaded ; 
but  when  the  people  who  carry  on  this  business  are  compelled  to  lay 
bare  to  the  proper  officials  each  and  every  transaction  they  have  en- 
gaged in,  you  then  strike  at  the  root  of  the  evil,  and  are  in  a  position 
to  apply  the  needed  remedy.  It  has  been  stated  that  this  section  is' 
impracticable,  or,  if  practicable,  it  would  involve  considerable  ex- 
pense and  labor.  We  denjr  this  for  the  reason  that  now,  and  for 
many  months  past,  the  Society  for  Savings  has  in  daily  use  such  a 
register,  and  after  experience  feels  that  it  is  the  only  method  whereby 
it  can  be  seen  at  a  glance  that  charges  have  been  paid  by  the  bor- 
rower, and  for  what  purposes.  We  think,  though,  this  section  would 
be  strengthened  were  it  amended  so  as  to  require  an  annual  state- 
ment in  the  form  of  a  trial  balance  of  its  books,  on  the  31st  day  of 
December  in  each  year,  specifying  the  different  kinds  of  its  liabili- 
ties and  the  different  kinds  of  its  assets,  stating  the  amount  of  each, 
together  with  such  other  information  as  may  be  called  for.  This 
statement  should  be  furnished  to  the  District  Commissioners  on  or 
before  the  20th  day  of  January  in  each  year  by  each  individual  or 
company  engaged  in  this  business,  and  they  should  also  print  this 
statement  or  trial  balance  in  at  least  one  newspaper  of  general  circu- 
lation in  Washington,  in  such  manner  as  may  be  directed  by  the 
District  Commissioners. 

Inspection  by  state  officials  designated  by  law  and  annual  reports 
of  the  business  are  required  in  New  York,  Massachusetts,  and  Rhode 
Island,  likewise  the  publishing  of  annual  reports. 

Sec.  5.  That  no  such  person,  firm,  corporation,  company,  or  association  shall 
charge  or  receive  a  greater  rate  of  interest  or  discount  upon  any  loan  made  by 
him  or  it  than  two  per  centum  per  month,  and  a  sum  not  exceeding  three  dol- 
lars for  the  first  examination  of  the  property  to  be  mortgaged,  or  the  investi- 
gation of  the  credit  or  responsibilty  of  indorsers  or  sureties  when  an  indorsed 
note  is  taken  as  security,  and  for  drawing  the  necessary  papers,  which  charge 
shall  include  all  services  of  every  character  in  connection  with  the  loan,  except 


314  BEPOBTS   OP   THE  PRESIDENT'S  HOMES  COMMISSION. 

upon  the  foreclosure  of  the  security,  and  no  additional  sums,  either  in  the  way 
of  bonus  or  otherwise,  shall  be  required  or  exacted  of  borrowers;  nor  shall  it  be 
lawful  to  divide  or  split  up  loans  under  any  pretext  whatsoever  for  the  purpose 
of  requiring  or  exacting  any  other  or  greater  charge  than  herein  prescribed. 
The  foregoing  interest  and  charge  may  be  deducted  from  the  principal  of  the 
loan  when  the  same  is  made.  No  such  loan  greater  than  five  hundred  dollars 
shall  be  made  to  any  one  person. 

The  provisions  of  section  5  restricting  the  amount  of  such  loans 
and  legalizing  a  rate  of  interest  not  higher  than  2  per  cent  per  month, 
and  a  fixed  charge  not  in  excess  of  $3  for  examining  the  property  to 
be  mortgaged  and  drawing  the  necessary  papers,  are  taken  from  the 
acts  of  State  legislatures,  which  will  be  now  noticed  at  some  length, 
as  also  will  be  the  business  of  some  of  the  corporations  operating 
under  them. 

By  the  laws  of  the  State  of  New  York,  chapter  326,  Laws  of  1895, 
as  amended  by  chapter  706,  Laws  of  1895,  entitled  "An  act  to  provide 
for  the  incorporation  of  associations  lending  money  on  personal 
property,  and  to  forbid  certain  loans  of  money,  property,  or  credit," 
it  is  provided : 

Sec.  3.  ♦  *  *  It  [every  such  corporation]  shall  be  entitled  to  charge  and 
receive  upon  such  loan  made  by  it  without  the  actual  delivery  to  it  of  the 
property  pledged  or  mortgaged,  which  charge  shall  include  all  services  of  every 
character,  in  connection  with  said  loan,  except  upon  the  foreclosure  of  the 
security,  interest  or  discount  at  a  rate  of  not  exceeding  three  per  centum  per 
month  for  a  period  of  two  months  or  less,  and  not  exceeding  two  per  centum 
per  month  for  any  period  after  said  two  months ;  and  also  a  sum  not  exceeding 
three  dollars  for  the  first  examination  of  the  property  to  be  pledged  or  mort- 
gaged and  for  drawing  and  filing  the  necessary  papers. 

It  will  be  observed  that  section  5  of  the  proposed  bill  is  copied 
•substantially  from  this  law. 

VI.     METHODS     IN     FORCE    IN     NEW     YOEK,     MASSACHUSETTS,    BHODE     ISLAND,     AND 

MARYLAND. 

The  laws  of  the  above-named  States  will  now  be  noticed  at  some 
length,  as  will  be  also  the  business  of  some  of  the  corporations  operat- 
ing under  them. 

New  York. — The  Provident  Loan  Society  of  New  York  was  organ- 
ized under  chapter  295  of  the  Laws  of  1894.  The  New  York  legis- 
lature granted  a  special  charter  to  carry  on  this  business  to  Otto  T. 
Bannard,  Charles  C.  Beaumen,  Henry  R.  Beekman,  William  L.  Bull, 
Frederic  R.  Coudert,  Charles  F.  Cox,  John  D.  Crimmins,  R.  Fulton 
Cutting,  Robert  W.  de  Forest,  William  E.  Dodge,  Charles  S.  Fair- 
child,  David  H.  Greer,  Abratn  S.  Hewitt,  James  J.  Higginson, 
Adrian  Iselin,  jr.,  D.  Willis  James,  John  S.  Kennedy,  Seth  Low, 
Solomon  Loeb,  Alfred  B.  Mason,  Victor  Morawetz,  J.  Pierpont 
Morgan,  Oswald  Ottendorfer,  Jacob  H.  Schiff,  Gustave  H.  Schwab, 
Charles  S.  Smith,  James  Speyer,  Walter  Stanton,  J.  Kennedy  Tod, 
Abraham  Wolff,  and  Cornelius  Vanderbilt,  together  with  such  per- 
sons as  they  may  associate  with  themselves.  These  gentlemen  are 
among  the  most  prominent  and  substantial  in  the  city  of  New  York. 
Section  3  of  said  act  reads  as  follows : 

Said  society  shall  be  entitled  to  act  as  pawnbroker,  and  shall  be  subject  to 
and  entitled  to  all  the  benefits  of  all  the  provisions  of  the  laws  of  this  State 
concerning  pawnbrokers,  except  that  it  shall  not  be  required  to  obtain  a  license 
or  file  a  bond. 


KEPORTS   OF   THE  PEESIDENT's  HOMES  COMMISSION.  315 

This  society  is  allowed  under  the  law  to  charge  interest  at  the  rate 
of  not  exceeding  3  per  cent  per  month,  and,  notwithstanding  its  stu- 
pendous capital  and  the  fact  that  it  is  classed  as  a  benevolent  society, 
it  actually  charges  as  interest  on  all  loans  made  1  per  cent  per  month. 
From  the  thirteenth  annual  report  of  said  society,  for  the  year  1907, 
it  appears  that  the  capital  employed  at  the  close  of  the  year  1907 
was  $5,001,586.14,  that  the  amount  loaned  during  said  year  was 
$10,601,000,  and  that  the  average  single  loan  was  $37.46.  On  page  11 
of  the  report  of  1905,  in  advocating  making  pawn  offices  accessible 
to  the  working  classes,  this  statement  will  be  found : 

The  need  of  the  workng  classes,  who  form  the  great  army  of  borrowers,  can 
best  be  met  by  making  the  pawn  office  accessible  to  them.  Convenience  of  ac- 
cess is  even  more  important  than  a  low  rate  of  interest.  This  is  evidenced  by 
the  great  growth  of  our  own  Eldridge  street  branch,  on  the  East  Side,  where 
the  transactions  already  largely  exceed  those  of  the  Fourth  avenue  office.  It 
is  also  evidenced  by  the  fact  that  many  prefer  to  patronize  an  adjacent  pawn- 
broker whose  rate  of  interest  is  much  higher  than  that  charged  by  this  society 
rather  than  go  a  little  out  of  their  way  to  one  of  our  offices.  The  benevolent 
purpose  of  the  society  will  be  far  better  effectuated  by  an  increase  in  the  num- 
ber of  our  branches  than  by  any  lowering  of  the  rate  of  interest,  even  if  such 
a  course  were  otherwise  desirabre.  Most  loans  are,  or  are  intended  to  be,  for 
a  short  period  when  made.  Car  fares  and  loss  of  time  count  for  more  than  a 
higher  interest  charge. 

Could  there  possibly  be  any  stronger  argument  as  to  the  necessity 
for  legalizing  a  reasonable  rate  of  interest  on  such  loans  than  the 
operations  of  this  society  ?  It  has  a  vast  capital,  most  of  it  made  up 
by  gifts  or  bequests  and  contributions  from  the  rich,  and  is  operated 
not  primarily  for  profit,  and  yet  it  actually  charges  1  per  cent  per 
month  on  its  loans  and  is  allowed  by  law  to  charge  3  per  cent  per 
month. 

The  report  of  the  president  for  1907  shows  that — 

In  1895,  our  first  full  year,  we  had  one  small  loaning  office,  which  made  20,804 
loans,  amounting  to  $377,845 ;  in  1907,  with  six  loaning  offices  in  operation,  283,- 
045  loans,  amounting  to  $10,601,557,  were  made.  In  1895,  18,214  loans,  amount- 
ing to  $322,596,  were  repaid,  whereas  in  1907  the  number  was  254,663,  amount- 
ing to  $9,840,379.  Again,  the  interest  earnings,  amounting  in  1895  to  $23,847, 
reached  in  1907,  the  large  sum  of  $564,534.  The  enormous  attention  to  detail 
involved  in  the  successful  conduct  of  this  business  becomes  apparent  when 
one  considers  that  the  average  of  the  loans  made  in  1907  was  $37.46. 

The  same  comparison  holds  good  as  to  the  personnel  and  organization  of  the 
society.  From  a  rented  office  with  a  staff  of  four  or  five  people,  employing 
$100,000  capital,  it  has  become  a  great  fiscal  institution  of  $5,000,000  capital, 
a  large,  well-trained  staff  of  about  sixty  employees,  with  six  offices.     *     ♦     * 

Of  course,  everyone  will  realize  that  the  smaller  the  loan  on  personal  prop- 
erty the  less  the  margin  of  profit,  as  the  percentage  of  operating  expenses  is 
proportionately  larger  when  a  small  loan  is  made  than  when  made  in  large 
amounts.  The  executive  committee  decided  that  on  November  1,  1907,  in  view 
of  the  increased  cost  of  capital  and  the  greater  cost  of  handling  an  increasing 
volume  of  small  loans  (192,060  being  for  $25  and  under,  91,754  being  for  $10 
and  under,  and  44,450  being  for  sums  of  $25  to  $50)  all  renewals,  as  well  as  all 
new  loans,  should  be  at  the  interest  rate  of  1  per  cent  per  month  or  fraction 
thereof,  except  those  repaid  within  two  weeks  from  date  of  making,  when  one- 
half  per  cent  only  would  be  charged. 

Mr.  Frank  Tucker,  the  vice-president  and  executive  officer,  at  a 
conference  held  with  a  committee  of  our  Society  for  Savings  of 
Washington,  in  July,  1908,  stated  that  the  handling  of  small  loans 
a't  1  per  cent  per  month  was  purely  a  charitable  propo'sition  and  so 


316  REPORTS  OF  THE  PRESIDENT'S  HOMES  COMMISSION. 

regarded  by  his  society,  but  an  absolute  impossibility  to  any  concern 
with  a  smaller  capital,  and  submitted  the  following  figures  as  proof : 

Number  of  loans  made  1907,  283,045. 

Operating  expenses,  excluding  dividends,  $127,052.62,  or  a  cost  per  loan  of 
45  cents. 

Cost  of  $10  loan  to  society,  45  cents. 

Dividend  of  6  per  cent  per  annum  on  $10,  60  cents. 

A  loan  of  $10  cost  the  society  for  one  year,  $1.05. 

Ten  dollars  at  1  per  cent  per  month  earns  the  society  for  one  year  $1.20, 
or  a  loan  of  $10  for  the  first  nine  months  merely  earned  its  cost  of  handling, 
but  that  2  per  cent  per  month  was  more  reasonable  and  a  fair  business  propo- 
sition. 

The  Provident  Loan  Company,  of  Buffalo,  was  incorporated  under 
the  aforementioned  act,  and  a  reading  of  the  annual  reports  of  said 
company  and  of  the  other  companies  or  societies  hereinafter  men- 
tioned will  be  interesting  to  those  who  care  to  investigate  further  into 
this  matter.  The  rate  of  interest  charged  by  the  Provident  Loan 
Company,  of  Buffalo,  is  3  per  cent  per  month  for  the  first  month, 
and  2  per  cent  for  each  month  thereafter,  and  a  charge  of  $3  for  ex- 
amination of  property  and  recording  of  mortgages,  etc.,  the  rate 
allowed  by  law.  It  is  said  in  one  of  the  annual  reports  of  this  com- 
pany that  "its  purpose  is  the  same  as  that  of  the  Workingmen's 
Loan  Association,  of  Boston,  founded  by  Robert  Treat  Paine  in  1887, 
and  its  methods  of  business  are  closely  patterned  after  those  in  use 
by  that  association."  (See  First  Annual  Report,  September  9,  1895, 
to  September  30,  1896.)  The  Workingmen's  Loan  Association,  of 
Boston,  was  one  of  the  pioneers  in  this  line  of  business.  The  law 
under  which  it  was  incorporated  and  its  operations  will  be  alluded  to 
further  on. 

Massachusetts. — By  an  act  of  the  legislature  of  the  State  of  Massa- 
chusetts entitled  "  An  act  to  incorporate  the  Pawner's  Bank,"  ap- 
proved April  5, 1859,  it  is  provided  by  section  4  that — 

The  charge  on  all  loans  to  cover  expenses  of  every  kind,  including  interest, 
shall  be  uniform,  and  not  to  exceed  one  and  one-half  per  cent  per  month. 

This  act  was  amended  by  an  act  entitled  "An  act  to  amend  the 
charter  of  the  Pawner's  Bank  of  Boston,"  approved  June  21,  1869. 
Section  2  thereof  reads  as  follows: 

The  charge  on  loans,  to  cover  expenses  of  every  kind,  including  interest, 
need  not  be  uniform,  but  may  be  regulated  by  the  bank,  but  it  shall  in  no 
case  exceed  two  per  cent  per  month. 

This  so-called  bank  is  still  in  business,  but  it  is  now  operated  under 
the  name  of  the  Collateral  Loan  Company  of  Boston.  The  total 
amount  of  the  loans  made  by  it  for  the  year  1905  amounted  to 
$2,092,566.08.    The  average  single  loan  was  $22.78. 

The  Workingmen's  Loan  Association  of  Boston  was  incorporated 
by  an  act  of  the  legislature  of  Massachusetts  approved  March  8, 
1888,  entitled  "An  act  to  incorporate  the  Workingmen's  Loan  Asso- 
ciation." By  this  act  a  charter  was  granted  to  Robert  Treat  Paine, 
Charles  W.  Dexter,  John  S.  Blatchford,  Francis  C.  Foster,  John 
D.  W.  French,  I.  Wells  Clarke,  George  W.  Pope,  Charles  H.  Wash- 
burn, Robert  Treat  Paine,  second,  Thomas  T.  Stokes,  and  Henry  R. 
Gardner,  and  their  associates  and  successors.  The  association  was 
authorized  to  loan  money  upon  pledge  or  mortgage  of  goods  and 
chattels,  and  on  safe  securities  or  every  kind,  or  upon  mortgage  of 


BEPORTS   OP   THE  PRESIDENT'S  HOMES  COMMISSION.  317 

real  estate.  The  capital  stock  of  the  association  is  $125,000.  The 
amount  of  outstanding  loans  on  April  1,  1908,  was  $215,826.64,  the 
number  of  borrowers  was  3,585,  and  the  average  single  loan  was 
about  $60.  ( See  the  Twentieth  Annual  Report  of  the  Workingmen's 
Loan  Association,  dated  April  16,  1908.)  In  a  pamphlet  published 
by  the  Massachusetts  board  of  managers.  World's  Fair,  in  1893, 
entitled  "  Origin  and  system  of  the  Workingmen's  Loan  Associa- 
tion," on  page  5  appears  the  following  statement : 

The  charge  for  interest  is  1  per  cent  per  month.  An  additional  charge  is 
made  on  the  making  of  each  loan  sufficient  to  cover  all  money  expended  in 
investigation  and  recording  the  mortgage,  and  to  give  the  company  in  ordinary 
cases  $1.65  for  the  time  spent  in  appraisal  and  drawing  papers.  Nearly  all 
of  the  loans  of  the  company  are  made  on  chattel  mortgage  of  furniture  and 
household  effects. 

This  has  been  amended,  and  at  the  present  time,  October,  1908, 
the  association,  in  addition  to  its  regular  rate  of  1  per  cent  per 
month,  charges  for  investigation,  recording  of  mortgages,  etc.,  the 
sum  of  $2.50  on  loans  under  $50,  $3  on  loans  of  $50  to  $250,  and 
$5  on  loans  over  $250 ;  $1  is  the  cost  charged  for  renewals.  No  loan 
is  made  for  less  than  $25  on  account  of  the  cost  of  handling,  which 
amounts  to  $3.77,  although  the  cost  of  recording  chattel  mortgages 
in  Massachusetts  is  but  75  cents,  and  no  notarial  certificate  is  required 
on  this  class  of  mortgages. 

The  association  also  charges  25  cents  on  loans  under  $50,  and  50 
cents  on  loans  from  $50  to  $100,  to  compensate  the  association  for 
the  risk  of  loss  of  goods  mortgaged,  by  fire,  though  no  insurance 
policy  is  taken  out  on  the  goods  mortgaged  as  security  for  such  small 
loans.  Thus  it  will  be  seen  that  the  association  receives  interest  on 
its  ordinary  small  loans  for  short  periods  of  time  of  at  least  2  per 
cent  per  month,  and  sometimes  more.  Robert  Treat  Paine,  of  Bos- 
ton, a  gentleman  of  national  reputation,  was  the  first  president  of 
this  association,  and  he  has  been  continuously  reelected  to  the  same 
office  to  the  present  time. 

In  1908  the  legislature  passed  an  act  entitled  "  An  act  to  regulate 
further  the  business  of  making  small  loans  "  (chap.  605,  1908),  which 
act  confers  on  the  police  commissioner  of  Boston,  and  upon  the 
mayor  in  other  cities,  the  power  to  make  the  rate  of  interest  to  be 
charged  upon  small  loans  of  $200  or  less,  upon  which  a  rate  of  in- 
terest greater  than  12  per  cent  per  annum  is  charged,  and  for  which 
no  security,  other  than  a  note  or  contract  with  or  without  indorsers 
is  taken,  having  due  regard  to  the  amount  of  the  loan  and  the  time 
for  which  it  is  made. 

It  also  fixed  the  charges  or  cost  as  follows : 

Sec.  3.  ♦  *  *  An  amount  not  exceeding  $2  if  the  loan  does  not  exceed  $25 ; 
not  exceeding  $10  if  the  loan  exceds  $100 ;  not  exceeding  $3  if  the  loan  exceeds 
$25  but  does  not  exceed  $50;  and  not  exceeding  $5  if  the  loan  exceeds  $50  but 
does  not  exceed  $100,  may,  if  both  parties  to  the  loan  so  agree,  be  paid  by  the 
borrower  or  added  to  the  debt,  and  taken  by  the  lender  as  the  expense  of  mak- 
ing the  loan,  and  such  amount  shall  not  be  counted  as  part  of  the  interest  on 
the  loan.  A  greater  amount  than  that  above  specified  shall  not  be  taken  for 
such  purpose,  and  any  money  paid,  promised,  or  taken  in  excess  of  such  amount 
shall  be  deemed  to  be  interest. 

Under  the  power  conferred  on  the  police  commissioner  of  Boston 
to  make  the  rate  of  interest  that  may  be  charged  on  said  class  of  small 


318  EEPORTS   OF   THE  PEESIDENt's  HOMES  COMMISSION. 

loans,  for  which  no  security  is  taken  other  than  a  note  or  contract 
with  or  without  indorser,  he  has  made  the  following  rates : 

Sec.  3.  Interest  may  be  charged  by  persons  licensed  under  this  rule  as  fol- 
lows: 

On  loans  not  exceeding  $50,  at  the  rate  of  36  per  cent  per  annum ;  on  loans  of 
over  $50,  at  the  rate  of  30  per  cent  per  annum. 

The  license  tax  for  this  class  of  business  is  $50  per  annum. 

Rhode  Island. — By  an  act  of  the  general  assembly  of  the  State  of 
Rhode  Island,  passed  February  28, 1895,  entitled  "  An  act  to  incorpo- 
rate the  Workingmen's  Loan  Association,"  it  is  provided  that  the 
rate  of  interest  on  loans  to  be  made  by  said  association  "shall  not 
exceed  1  per  cent  a  month."  (See  sec.  4  of  said  act.)  This  act  was 
amended  on  May  27,  1897,  and  the  rate  of  interest  on  such  loans  was 
raised  not  to  exceed  2  per  cent  per  month,  which  rate  is  still  in  force. 
Section  4  of  said  act  as  amended  reads  as  follows : 

All  loans  shall  be  for  a  time  fixed,  and  for  not  more  than  one  year,  and  the 
mortgagor  or  pledgor  shall  have  a  right  to  redeem  his  property  mortgaged  or 
pledged  at  any  time  before  it  is  sold,  pursuant  to  the  contract  between  said 
mortgagor  or  pledgor  and  said  corporation,  or  before  the  right  of  redemption 
is  foreclosed,  on  the  payment  of  the  loan  and  interest  at  the  time  of  the  offer 
to  redeem.  No  loan  of  more  than  one  thousand  dollars  shall  be  made  to  any 
one  person.  The  rate  of  interest  upon  any  loan  made  by  said  corporation  shall 
not  exceed  two  per  cent  a  month.  No  dividend  shall  be  paid  in  excess  of  six 
per  cent  per  annum. 

'Maryland. — An  act  of  the  Maryland  legislature  of  1902,  regulating 
the  loaning  of  money  when,  as  security  for  such  a  loan,  a  lien  is  taken 
upon  household  furniture  and  effects,  musical  instruments,  typewrit- 
ers, and  sewing  machines,  authorizes  a  charge  for  the  examination  or 
valuation  of  property  offered  as  security  for  a  loan  and  the  prepara- 
tion of  the  necessary  papers,  as  follows: 

On  sums  of  $1  to  $50,  a  charge  of  $5 ;  on  sums  of  $51  to  $100,  a  charge  of  $6 ; 
on  sums  of  $101  to  $1,000,  a  charge  of  $6  plus  5  per  cent  of  increase  over  $100 ; 
on  sums  of  $1,001  and  upvrard,  a  charge  of  $6  plus  5  per  cent  of  increase 
over  $100  and  plus  2\  per  cent  of  increase  over  $1,000. 

The  said  act  also  authorizes  the  collection  of  the  amount  actually 
to  be  paid  for  recording  papers,  revenue  stamps,  and  fire-insurance 
premiums.  While  all  of  the  loans  under  this  act  only  bear  interest 
at  the  rate  of  6  per  cent  per  annum,  it  is  plain  that  the  fixed  charges 
by  law  more  than  raise  the  actual  rate  of  interest  to  2  per  cent  per 
month  on  ordinary  short-time  loans. 

Chapter  XV. 

HOW  TO  BENEFIT  THE  POOR  IN  THE  SLUMS, 
[By  Wm.  F.  Downey.] 

For  many  years  the  board  of  trade  and  other  civic  associations  have 
shown  a  deep  interest  in  the  material  improvements  in  Washington. 
Each  year  we  have  the  reports  of  various  committees  on  improve- 
ments, embracing  the  departments  of  public  buildings,  parks,  bridges, 
harbors,  streets,  trees,  sewers,  manufactures  and  commerce,  rail- 
roads, etc.,  in  which  recommendations  are  made  that  millions  of  dol- 
lars be  appropriated  for  such  improvements. 


REPOBTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  319 

While  it  is  very  commendable  of  our  citizens  to  use  every  means 
possible  pertaining  to  the  manufacturing  and  commercial  progress 
and  material  welfare  of  our  city,  we  should  not  overlook  that  portion 
where  the  poor  dwell  in  slums,  alleys,  and  courts,  in  unsanitary  and 
uninhabitable  abodes.  We  can  not  truthfully  boast  of  or  take  pride 
in  our  capital  city  until  we  improve  the  conditions  of  our  slum  prop- 
erty and  remove  the  festering  plague  spots  which  are  equally  a  men- 
ace to  the  health  and  morals  of  the  community. 

Our  attention  must  be  directed  to  these  slums  and  plague  spots 
where  the  poor  are  forced  to  live.  As  long  as  these  sources  of  pov- 
erty and  crime  are  allowed  to  exist  in  our  city,  and  are  tolerated  by 
law,  there  is  little  use  in  attempting  to  reform  them ;  such  evil  haunts 
are  so  many  poison  springs  constantly  throwing  forth  their  putrid 
waters  over  our  city,  and  until  they  are  purified  all  moral  efforts  will 
avail  but  little. 

The  surgeon  who  is  called  to  treat  a  patient  does  not  devote  his 
services  to  the  sound  parts  of  the  body,  but  immediately  directs  his 
attention  to  the  diseased  spot.  So  it  behooves  us  to  apply  our  reme- 
dies to  the  slums  and  plague  spots  of  the  community,  where  poverty 
prevails,  immorality  is  rampant,  and  crime  originates  and  flourishes. 

We  notice  that  the  health  authorities  in  every  town  and  city  in 
the  land  are  endeavoring  to  prevent  or  check  infectious  diseases,  and 
if  anyone  becomes  infected,  that  one  is  immediately  quarantined. 
Similar  precautions  are  taken  in  the  case  of  steamers  arriving  in  port 
with  contagiously  diseased  patients  on  board.  While  this  all-im- 
portant attention  is  given  to  such  cases,  why  should  we  permit  greater 
evils  to  exist  which  spread  their  blasting  effects  through  the  com- 
munity, and  transfer  the  contagion  from  generation  to  generation, 
such  as  consumption  and  other  diseases,  emanating  from  immoral 
lives  due  to  dens  of  infamy,  low  saloons,  etc.  ?  Insanitary  and  unin- 
habitable dwellings,  where  people  are  crowded  together,  breed  and 
spread  considerable  disease.  For  instance,  many  people  live  in  these 
places  at  night,  and  work  in  homes  all  over  the  city  during  the  day. 
In  this  way  the  disease  germs  are  carried  into  many  homes,  endanger- 
ing the  health  of  our  little  ones  and  blighting  the  happiness  of  our 
people. 

Much  praise  is  due  to  Mr.  Charles  F.  Weller,  and  those  connected 
with  the  Associated  Charities  for  the  light  they  have  thrown  on  the 
slum  problem,  and  the  aid  they  have  rendered  to  those  who  dwell 
there;  also  the  Washington  Sanitary  Housing  Company,  which  has 
aided  so  many  people  of  limited  means  to  secure  houses  a  moderate 
rental.  Squalid  shacks  have  disappeared  from  certain  quarters  and 
their  sites  are  now  occupied  by  habitable  dwellings ;  the  purpose  which 
brought  about  this  change  is  worthy  of  commendation.  Every  effort 
which  elevates  and  improves  land  and  houses  is  entitled  to  its  meed 
of  praise.  But  while  the  housing  movements  have  benefited  a  class 
of  people  who  are  able  to  pay  moderate  rents,  what  has  become  of 
the  unfortunates  who  dwell  in  shacks? 

It  is  an  easy  matter  to  stigmatize  the  unfortunate  with  the  names 
their  depraved  habits  deserve,  but  what  of  their  reform;  has  there 
been  anything  done  to  elevate  them,  to  cleanse  them,  to  withdraw 
them  from  their  evil  associates? 


320  BEPORTS  OF  THE  PRESIDENT'S  HOMES  COMMISSION. 

This  is  the  work  under  present  contemplation.  These  poor  crea- 
tures should  not  be  driven  to  desperation;  we  should  see  to  it  that 
means  are  available  to  effect  their  temporal,  physical,  and  moral 
welfare. 

It  may  be  a  work  meriting  all  praise  to  beautify  a  portion  of  the 
city  in  which  we  live,  enhancing  the  value  of  property  and  of  elevat- 
ing human  life.  Indeed,  it  will  be  cheerfully  conceded  that  such 
work  is  deserving  of  the  highest  praise.  But  how  incomparably 
better  is  the  merit  of  the  effort  and  toil  spent  in  uplifting  frail  mem- 
bers of  the  human  family.  They  are  for  eternity,  and  should  they 
not  be  impressed  with  the  knowledge  of  the  fact  "  Whatsoever  you 
do  to  the  least  of  these,  you  do  unto  Me,"  said  the  Savior  of  men. 

Shacks  and  shanties  may  be  transformed  into  residences  and  man- 
sions, but  they  will  crumble  away.  The  depraved  citizen  of  the 
slums  is  destined  for  eternity ;  he  is  made  in  the  image  of  God.  His 
being  known,  should  it  not  be  glorious  work  to  restore  the  Image, 
which  has  been  well-nigh  obliterated  by  dissipation  and  sin?  The 
merit  of  an  undertaking  is  due  to  the  object  and  the  aim.  Judged 
by  this  canon  how  supremely  meritorious  is  the  work  of  redeeming 
and  uplifting  those  who  have  fallen  away  from  their  high  inheritance 
as  children  of  God,  and  who  are  held  in  the  thrall  of  base  servitude. 
To  beautify  a  city  and  to  make  habitable  homes  is  a  work  of  com- 
merce and  art;  to  uplift  and  fortify  frail  humanity  is  to  cooperate 
with  Christ  in  the  work  of  redemption. 

If  the  Government  can  build  prisons  for  the  criminals,  almshouses 
for  the  poor,  asylums  for  the  afflicted,  and  public  schools,  libraries, 
etc.,  on  which  millions  of  dollars  have  been  spent,  it  would  seem  that 
in  common  sense  and  in  logic  there  can  be  no  condemnation  for  an 
application  of  the  same  solicitude  to  the  aid  of  those  who  are  in  a 
condition  of  semiparalysis,  owing  to  economic  conditions.  A  little 
government  aid  extended  to  these  unfortunates  in  the  form  of  a  loan 
to  build  them  habitable  dwellings  would  tend  immensely  toward  their 
uplifting  and  improvement. 

The  home  is  the  very  foundation  and  corner  stone  of  society,  and 
should  be  particularly  guarded  against  the  contamination  of  all  vice. 

All  unsightly  and  insanitary  property  should  be  condemned  and 
purchased  by  the  Government,  improved  in  a  uniform  manner,  and 
inexpensive  an  dhealthful  habitations  erected  for  the  poor,  who 
could  rent  or  purchase  these  homes  on  installment  plans,  at  low  rates 
of  interest.  Should  this  be  done,  all  would  be  benefited,  for  not  like 
money  spent  in  the  erection  of  prisons,  poorhouses,  libraries,  schools, 
etc.,  that  never  return  to  the  public  exchequer,  the  money  expended 
on  such  homes  would  return  in  the  form  of  re^lar  monthly  pay- 
ments, and  this  in  turn  could  be  used  for  the  continuance  and  spread 
of  the  good  work  of  elevating  the  masses. 

It  is  manifestly  unfair  to  exact  exhorbitant  rents  from  the  poorer 
classes;  the  poorer  a  man  is  the  more  he  is  at  the  mercy  of  the 
owner,  and  this  is  the  very  man  the  city  should  try  to  assist.  Think 
of  it — these  families  paying  rents  for  shacks,  which  give  a  gross 
return  to  the  owner  of  from  9  per  cent  all  the  way  to  35  per  cent; 
renters  pay  from  $6  per  month  to  $12.50  which  bring  in  these  large 
returns  of  interest.  (See  report  of  committee  on  building  model 
houses  in  Washington,  D.  C.,  1908.)  The  fact  that  these  renters 
pay  from  $6  to  $12.50  per  month  shows  that  they  are  among  the 


BEPOETS   OF   THE  PEESIDENt's  HOMES   COMMISSION.  321 

poorer  classes.  It  is  the  sick  man  who  needs  medicine ;  likewise  the 
poor  man  needs  assistance.  In  many  instances  there  is  little  or  no 
chance  of  his  coming  to  the  front  without  this  assistance. 

How  many  poor  helpless  creatures  born  in  the  slums  would,  if 
opportunity  were  given  to  them,  develop  in  a  pure  atmosphere  a 
noble  manhood  and  womanhood,  which  would  make  them  the  pride  of 
the  country,  instead  of  becoming  or  remaining  a  burden  to  the  com- 
munity? They  might  become  some  of  the  best  citizens  and  bright- 
est statesmen  if  their  childhood  days  were  rescued  from  unhallowed 
surroundings.  This  is  no  dream,  but  the  actual  experience  of  the 
writer,  who  has  succeeded  in  helping  numbers  of  individuals  and 
families  to  become  self-helpful  and  rise  to  the  highest  grade  of 
citizens. 

We  read  in  the  newspapers  of  the  day  of  eminent  men,  well  quali- 
fied to  speak  on  the  subject,  making  an  outcry  against  the  wasteful 
use  of  coal,  iron,  and  timber  and  predicting  a  famine  of  the  same  in 
future  generations.  While  this  subject  is  very  commendable,  I  sin- 
cerely hope  the  day  is  not  far  distant  when  the  distinguished  people 
will  also  consider  the  temporal  and  moral  welfare  of  the  citizens, 
which  I  think  should  be  regarded  as  the  most  important  of  all 
subjects,  as  it  does  not  only  pertain  to  the  permanent  and  thorough 
improvement  and  beautifying  of  our  national  capital  city,  but 
pertains  chiefly  to  the  uplift  of  our  citizens. 

It  is  only  the  Federal  Government  which  controls  the  affairs  of  the 
city  of  Washington,  which  could  undertake  such  a  necessary  and 
meritorious  work,  by  having  an  act  passed  by  Congress  giving  power 
to  appoint  three  men — an  engineer,  an  architect,  and  a  sanitary  engi- 
neer— with  power  to  condemn,  purchase,  and  improve  property  m 
squares  having  narrow  minor  streets,  and  alleys  without  proper  open- 
ings. Many  of  such  squares  are  crowded  with  insanitary  and  unin- 
habitable dwellings,  which  make  them  a  menace  to  the  health  and 
morals  of  the  unfortunate  people  who  are  forced  to  dwell  there.  This 
seems  to  be  the  only  correct  way  to  deal  practically  with  this  question, 
and  it  readily  appeals  to  the  intelligence  and  desire  of  every  good 
citizen  who  has  the  welfare  of  our  city  and  citizens  at  heart. 

See  the  great  advantage  which  would  be  derived  from  such  an 
undertaking.  The  commission  suggested,  of  three  gentlemen,  would 
first  map  out  the  improvements  to  be  made  in  such  squares,  and  after 
the  condemnation  of  certain  lots  and  parts  of  lots,  then  to  erase  all 
unsightly  buildings  from  the  land,  so  that  the  improvements  could 
be  made  in  a  uniform  manner  by  grading  and  beautifying  the  land, 
and  erect  houses  on  the  most  suitable  plan.  The  streets  in  such 
squares  should  not  be  less  than  40  feet  wide  from  building  to  build- 
ing to  be  divided  in  the  following  manner :  Take  10  feet  in  the  center 
for  a  parking,  where  trees  could  be  planted,  giving  good  shade  in 
summer  to  the  occupants  of  the  houses  on  each  side  of  the  street  and 
affording  15  feet  roadway  for  each  side  of  the  street.  This  parking 
and  arrangement  of  the  streets  through  squares  would  afford  the 
children  ample  playgrounds  and  save  them  from  the  many  dangers 
liable  to  happen  on  the  public  streets  from  trolley  cars,  teams,  au- 
tomobiles, etc.  Of  course  there  are  other  methods  for  street  construc- 
tion, but  the  one  here  suggested  would  no  doubt  be  desirable,  and 
S.  Doc.  644,  60-2 22 


322  KEPORTS   OF   THE   PRESIDENT'S   HOMES   COMMISSION". 

give  the  houses  air  and  sunshine,  so  essential  to  afford  a  bright, 
healthful  home. 

The  police  department  could  carry  on  this  work  without  additional 
expense  to  the  Government ;  the  police  officers  could  not  only  be  made 
preservers  of  law  and  order,  but  also,  as  far  as  possible,  suppress 
and  remove  every  source  of  evil,  particularly  those  endangering  the 
morals  of  our  youth.  They  could  also  be  made  the  sanitary  inspectors 
and  collect  the  monthly  rents  and  installments  from  the  people  who 
rent  or  purchase  these  houses.  This  money  would  go  right  back  into 
the  funds  of  the  Government,  and  be  available  for  the  improvement 
of  other  such  property,  which  in  time  would  eliminate  every  unde- 
sirable and  uninhabitable  house  in  the  city. 

If  such  an  arrangement  would  be  adopted  it  would  bring  about  an 
entire  change  in  our  city  government,  for  instead  of  the  police  officers 
being  the  prosecutors  and  persecutors  of  our  unfortunate  and  crimi- 
nal classes,  who  are  ruined  by  the  existing  vices  spread  nearly  every- 
where, they  would  suppress  and  remove  as  far  as  possible  the  vices 
and  save  the  citizens.  I  predict  if  this  plan  was  put  in  operation  it 
would  reduce  the  criminal  class  more  than  50  per  cent.  The  police- 
man should  act  as  the  good  Samaritan,  which  would  elevate  him  to 
the  highest  rank  in  public  service  and  make  him  beloved  and  re- 
spected by  every  good  citizen.  In  this  way  they  could  be  made  the 
greatest  power  for  good. 

While  this  plan  is  perhaps  new  in  our  country,  somewhat  similar 
plans  have  worked  successfully  in  several  foreign  countries.  I  know 
that  foreign  experiences  do  not  apply  fully  to  our  country,  and  a  plan 
might  work  successfully  there  and  not  here  on  account  of  different 
political  and  social  conditions,  but  the  problem  is  about  the  same  and 
its  solution  is  of  basic  importance.  We  can  profit  by  foreign  ex- 
perience and  modify  the  plan  so  as  to  meet  our  social  and  political 
conditions.  I  submit  the  plan  herein  outlined.  Having  the  problem 
to  deal  with  in  the  United  States,  we  should  be  the  leaders  and  not 
the  followers. 

Granting,  then,  that  the  problem  exists  and  that  the  United  States 
should  lead  in  its  solution,  I  know  of  no  city  where  it  could  be  tried 
to  better  advantage  than  in  the  city  of  Washington,  and  its  success 
here  would  mean  in  time  its  success  in  every  city  in  our  country. 
There  is  no  reason  why  our  city  should  not  be  the  finest  in  the  world, 
morally  as  well  as  materially  and  intellectually,  and  it  soon  would 
be  if  we  set  about  it  in  the  right  way.  We  have  already  secured  pres- 
tige as  a  center  of  art,  letters,  and  legislation.  Let  us  endeavor  like- 
wise to  protect  and  influence  our  citizens  to  the  highest  moral  stand- 
ard by  aiding  them  to  secure  better  homes  and  to  guard  and  protect 
them  from  the  contaminating  influence  which  now  confronts  them 
everywhere. 


Appendix  A. 

HEALTH    OF    EMPLOYEES    IN    THE    GOVERNMENT    PRINTING    OFFICE, 

WASHINGTON.^ 

[By  Wm.  J.  Manning,  M.  D.,  Medical  and  Sanitary  Officer,  Government  Printing  Office.] 

Owing  to  improved  hygienic  conditions  in  modern  printing  offices,  type  foun- 
dries, and  stereotype  and  electrotype  foundries,  lead  poisoning  now  exists  to  a 
very  limited  extent  in  these  trades. 

In  tlie  Government  Printing  Office  at  Washington,  where  upward  of  4,500 
employees  are  gathered  in  one  building,  excellent  hygienic  conditions  prevail. 
Every  ten  minutes  the  air  in  each  room  is  changed  by  a  very  simple  device, 
consisting  of  air  shafts  leading  from  the  basement  to  the  roof,  and  which  are 
pierced  in  each  room  near  the  ceiling  with  suitable  openings.  A  revolving  fan 
placed  just  below  the  roof  creates  a  suction,  so  that  a  constant  supply  of  fresh 
air  is  available  at  all  times,  owing  to  the  vacuum  thus  formed. 

The  electrotype  and  stereotype  foundries  are  placed  on  the  topmost  floor,  the 
modern,  rapidly  moving  elevators  making  this  practicable,  so  far  as  the  em- 
ployees are  concerned.  At  that  height  from  the  ground  currents  of  air  are  con- 
stantly in  motion,  with  a  consequently  greater  diffusion  of  the  gases  than  would 
prevail  on  floors  nearer  the  ground.  In  the  large  newspaper  buildings  of  the 
cities  in  the  United  States  the  same  idea  is  being  carried  out,  these  rooms  being 
placed  as  high  in  the  air  as  possible. 

In  the  type-founding  and  stereotyping  trades  employees  whose  duties  call  them 
to  work  over  the  fumes  of  the  melting  pots  are  most  exposed  to  the  injurious 
influences  of  lead,  although  the  large  amount  of  alloy  present  tends  to  lessen  the 
danger. 

"  Finishers "  of  the  plates,  who  handle  only  the  smooth,  hard,  bright  slabs 
of  the  alloyed  metal,  which  are  free  from  all  oxides,  run  the  least  risk  of  lead 
poisoning.  The  fact  that  there  is  little  or  no  dust,  coupled  with  the  fact  that 
the  small  particles  which  rub  off  the  plates  on  the  hands  of  the  workman  are 
in  the  metallic  state  and  perfectly  dry  renders  it  less  liable  to  be  absorbed.  In 
contradistinction  to  this  is  the  case  of  the  painter.  Here  the  lead,  being  in  the 
form  of  a  carbonate  (white  lead)  and  being  mixed  with  such  an  excellent 
absorbing  material  as  oil,  is  much  more  rapidly  absorbed. 

EMERGENCY  BOOM,   GOVERNMENT   PRINTING   OFFICE,    WASHINGTON,   D.   a 

In  type  foundries  practically  the  same  conditions  exist  as  in  electrotype 
foundries.  Those  who  work  in  the  vicinity  of  the  melting  pots  are  much  more 
liable  to  the  toxic  vapors  which  arise  from  the  melting  pot.  This  is  particularly 
the  case  where  the  lead  is  impure  and  contains  volatile  substances  which,  com- 
bining with  the  lead  fumes,  might  possibly  add  to  the  toxic  influences  of  the 
lead.  Hence,  in  "  fluxing  "  the  metal,  when  wax  is  used  as  the  agent,  as  little 
as  possible  should  be  used. 

Females  are,  as  a  rule,  employed  in  this  country  to  sort,  finish,  and  pack 
the  type.  Here,  as  with  the  "  finishers  "  in  the  electrotype  foundries,  the  metal 
is  bright  and  free  from  oxides,  besides  being  largely  alloyed ;  hence,  the  chance 

°'  Doctor  Manning's  article  on  Plumbism,  which  is  here  reproduced,  was  sub- 
mitted by  him  in  competition  for  a  prize  offered  by  the  Internationales  Arbeit- 
sant,  Basel,  Switzerland.  The  article  was  purchased  for  publication  by  that 
office  on  account  of  merit. 

828 


324  KEPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

of  absorption  with  toxic  results  is  greatly  lessened.  Doctor  Osier  has  pointed 
out  that  the  ratio  of  women  susceptible  to  lead  poisoning  is  small  as  com- 
pared with  men.  Why  they  are  thus  immune  is  hard  to  say ;  but,  so  far  as  type 
founding  is  concerned,  probably  the  above  statement  indicates  the  cause. 

With  the  compositor  the  chances  of  absorption  of  lead  from  the  type  metal 
by  the  skin  is  probably  nil.  Only  a  small  portion  of  the  epidermis  of  the 
fingers  (the  apex  of  the  thumb  and  forefinger)  is  brought  in  contact  with  the 
metal  both  in  "  distributing "  and  in  "  setting,"  and  the  epidermis  at  these 
parts  is  in  a  more  or  less  thickened,  dense  condition.  Thus,  the  compositor  is 
protected  from  absorbing  the  metal,  even  when  the  type  is  covered  with  the 
hydrate  which  is  formed  by  the  long-continued  action  of  air  and  water.  It 
is  well  known  that  substances  are  absorbed  but  slightly,  if  at  all,  through  the 
skin  that  is  in  a  thickened  condition.  If  one  will  stop  to  consider  that  the 
small  atoms  which  become  separated  from  the  metal  type  in  one  way  and 
another  are  in  a  metallic  form  the  chances  of  absorption  are  even  more  remote. 

The  danger  to  the  compositor,  as  with  the  melting-pot  tender,  would  seem  to 
lie  in  inhalation.  With  the  former  the  introduction  into  the  system  would  be 
by  dust,  and  with  the  latter  in  the  form  of  gas. 

When  foreign  bodies  are  taken  into  the  system  in  a  state  of  fine  subdivision, 
the  favorite  seat  will  be  found,  as  a  rule,  in  the  bronchi  and  the  lungs.  The 
process,  so  far  as  compositors  are  concerned,  might  be  termed  plumbiosis.  The 
dust  which  is  not  carried  directly  into  the  alveoli  of  the  lungs  by  the  air 
breathed  finds  lodgment  on  the  membrane  of  the  bronchi  and  the  ramifications 
thereof.  That  considerable  dust  is  carried  down  the  esophagus  into  the  stom- 
ach and  from  there  swept  out  into  the  intestines  is  not  to  be  doubted.  Might 
not  these  fine  particles  cause  the  "  colic  "  or  active  peristalsis  by  the  stimulation 
of  the  circular  and  longitudinal  muscular  fibers  in  a  mechanical  way  on  the 
muscles  themselves  or  in  a  chemic  way  by  a  stimulation  of  the  nerves  con- 
trolling these  fibers?  This  "colic"  is  one  of  the  first  symptoms  complained  of 
by  the  patient. 

That  the  white  blood  corpuscles  play  an  important  part  in  carrying  this 
finely  divided  substance  throughout  the  body  is  also  probable,  the  mode  of 
action  being  to  inclose  the  fine  particles  and  try  to  dissolve  them,  and,  failing 
in  that,  to  transport  them  to  distant  points  in  the  body  and  to  the  various 
organs.  In  that  condition  known  as  anthracosis,  or  coal-miner's  consumption, 
the  lung  is  found  to  be  covered  with  black  dust.  The  same  conditions  are 
found  in  those  suffering  from  stonecutter's  consumption,  the  lack  of  carbon 
rendering  the  pigment  somewhat  lighter  in  color.  The  condition  is  known  as 
lithosis.  In  the  knife  and  saw  sharpener's  trade  the  dust  is  in  the  form  of 
steel  and  the  consequent  disease  is  known  as  siderosis.  In  each  case  the 
fine  dust  finds  lodgment  in  the  lungs. 

The  lungs  become  so  pigmented  after  long  exposure  to  these  conditions,  and 
the  alveoli  so  congested  and  choked,  accompanied  by  a  low  form  of  inflamma- 
tion that  the  substances  set  up,  that  this,  with  the  unhygienic  surroundings  and 
bad  ventilation,  might  explain  why  so  many  compositors  die  each  year  from 
tuberculosis.  Certainly  the  tubercle  bacilli  find  a  congenial  environment  in 
which  to  begin  their  fatal  work.  To  the  above  conditions  must  be  added,  of 
course,  the  toxic  influence  of  the  lead  itself,  together  with  the  persistent  astrin- 
gent effect  of  the  lead  on  the  air  cells.  Lead  is  a  very  feeble  antiseptic  and  does 
not  seem  to  inhibit  the  growth  of  the  bacilli. 

The  lymph  nodes  very  likely  play  an  important  part  in  carrying  the  lead 
through  the  body  to  produce  plumbism.  When  lymph  nodes  become  loaded  with 
foreign  material  of  any  nature  they  are  apt  to  break  down  and  the  circulation 
carries  the  substances  to  various  parts  of  the  body.  This  would  seem  to  explain 
the  peculiar  color  of  those  suffering  from  plumbism,  and  it  might  explain  why 
the  kidneys  become  so  irritated  and  why  albumin  is  found  in  the  urine.  Certain 
tissues  seem  to  have  an  affinity  for  the  lead  thus  carried  and  it  is  deposited 
in  them.  The  blue  line  on  the  gums  which  is  pathognomic  of  lead  poisoning 
may  be  the  result  of  this.  It  may  be  that  sulphur,  which  has  such  a  strong 
affinity  for  lead  and  which  might  be  taken  into  the  mouth  in  articles  of  food 
and  drink  causes  this  pigmentation.  It  is  strange  that  the  blue  line  does  not 
make  its  appearance  on  any  other  part  of  the  body.  Certain  it  is  that  the 
potassium  sulphite  when  added  to  a  bath  will  bring  out  this  pigment  over  the 
entire  body,  which  remains  until  the  lead  in  the  skin  is  either  eliminated  or 
the  affinity  is  satisfied. 


REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  325 

Lead  poisoning  in  the  chronic  form,  as  already  stated,  is  very  rare  among 
type  founders,  electrotypers,  stereotypers,  and  in  the  printing  trades  in  this 
country.  It  may  present  itself  in  the  regular  type  or  the  symptoms  may  be 
hidden.  The  characteristic  symptoms  are  the  blue  line  on  the  gums,  and  the 
wrist  drop,  due  to  the  paralysis  of  the  extensors  of  the  forearms.  In  some 
cases  it  first  makes  its  appearance  in  anaemia  and  in  loss  of  strength.  Anses- 
thesia  may  appear  in  spots  on  different  parts  of  the  body,  the  spots  varying 
in  size  from  half  a  dollar  to  tracts  as  large  as  the  hand.  They  may  appear  on 
the  arms,  legs,  or  on  the  back.  In  some  cases,  however,  these  symptoms  are 
entirely  absent.  Albumin  may  appear  in  the  urine.  Doctor  Osier  describes 
cases  that  have  come  under  his  care  where  the  symptoms  resembled  gout  and 
rheumatism.  The  joints  would  swell  and  become  very  red  and  tender,  the 
patient  suffering  all  the  while  intense  pain.  Doctor  Wood  mentions  cases 
where  the  symptoms  resembled  actue  poliomyelitis.  In  other  cases  there  was 
simply  a  failure  of  health,  ansemia,  nervous  phenomena,  etc.,  the  patient  having 
ill-defined,  sharp,  shooting  pains.  The  pain  from  the  colic  seems  to  merge  from 
the  umbilicus  in  all  instances.  Arteriosclerosis  has  been  noticed  with  atrophy 
of  the  kidneys  and  hypertrophy  of  the  heart,  the  enlargement  of  the  latter 
organ  probably  being  due  to  the  redoubled  effort  of  the  heart  to  force  the 
blood  through  the  various  contracted  distal  organs.  This  contraction  may  be 
due  in  a  measure  to  the  astringent  action  of  the  lead  which  is  noticed  upon 
all  tissues  when  lead  is  applied  in  its  various  forms. 

The  treatment  in  these  cases  may  be  divided  into  the  preventive  and  cura- 
tive, the  former  relating,  of  course,  only  to  the  trades  mentioned  in  this  article. 
Among  the  measures  which  might  be  taken  in  the  prevention  of  plumb  ism  in 
the  printing,  type  founding,  and  electrotyping  and  stereotyping  trades  would 
be,  first  of  all,  the  location.  The  rooms  devoted  to  the  melting  of  type  metal 
should  be  situated  as  high  as  possible  in  the  air,  and  on  the  topmost  floor  of 
the  building.  The  pots  should  be  covered  with  iron  hoods  that  will  cover  the 
entire  top  of  the  melting  pot  proper.  The  hood  should  set  as  near  the  metal 
as  possible,  in  such  a  way  that  it  will  not  interfere  with  the  manipulation  of 
the  ladles  or  dippers.  Hoods  with  small  pipes  when  used  as  fume  chambers  do 
not  answer.  It  has  been  found  that  to  be  of  any  service  or  benefit,  the  pipe 
leading  from  the  hood  or  fume  chamber  should  be  nearly  as  large  as  the  cham- 
ber itself,  and  should  lead  to  a  smoke  chimney  or  into  the  outside  air.  The 
heat  generated  should  supply  draft  enough  to  carry  the  fumes  off  in  this  way. 
It  might  be  aided  by  placing  a  revolving  circular  ventilator  in  the  pipe  from 
the  outside  and  operated  by  the  wind.  The  whole  thing  might  be  made  very 
cheaply  of  galvanized  iron.  Various  face  masks  have  been  suggested,  but  none 
seem  to  be  practical,  and  after  they  are  worn  for  some  time  really  become  a 
greater  danger  than  if  they  had  not  been  used,  owing  to  the  lack  of  cleanli- 
ness. Cotton  and  such  substances  in  the  nose  are  useless,  because  the  workman 
will  then  breathe  through  his  mouth.  The  rooms  should  be  at  least  10  feet 
high.  Windows  should  be  placed  on  both  sides  of  the  room,  so  that  a  current 
of  air  may  be  in  constant  motion  and  a  fresh  supply  always  on  hand.  In 
winter  or  bad  weather  a  very  simple  way  to  obtain  fresh  air  consists  in  placing 
a  board  3  or  4  inches  high  lengthwise  under  the  lower  window  sash.  This  will 
enable  the  fresh  air  to  enter  between  the  lower  and  upper  windows  without 
causing  a  direct  draft  on  the  workmen. 

The  personal  treatment  on  the  part  of  the  workman  should  be  a  change  of 
underclothing  after  work,  a  bath  at  least  three  times  a  week  in  hot  water  with 
plenty  of  soap,  and  at  the  same  time  the  vigorous  application  of  a  flesh  brush 
to  the  skin.  The  object  here  is  twofold — to  keep  the  pores  free  and  to  remove 
any  particles  that  may  have  lodged  there,  and  hence  lessen  the  danger  of 
absorption,  while  at  the  same  time  helping  the  pores  to  eliminate  that  which 
has  been  absorbed.  The  bowels  should  be  kept  open  by  the  use  of  such  simple 
laxatives  as  sweet  oil,  castor  oil,  calomel  and  soda,  etc.  An  electrotyper  who 
has  been  in  the  business  for  some  forty  years,  and  who  is  now  the  chief  of  the 
largest  foundry  in  the  world,  informed  me  that  it  was  his  custom  to  take  a 
teaspoonful  of  sweet  oil  every  other  day,  and  that  he  had  never  suffered  from 
any  ill  effects  of  plumbism. 

So  far  as  compositors  are  concerned,  the  preventive  treatment  just  described 
would  apply  to  them.  The  principal  danger  here  is  the  bad  ventilation,  in- 
sanitary surroundings,  and  the  dust  (principally  graphite  and  minute  particles 
of  type  metal)  which  becomes  detached  by  the  abrasion  of  the  pieces  against 
each  other  while  being  handled.  To  offset  this,  "  cases  "  should  be  blown  out 
by  a  bellows  at  least  once  each  week ;  if  possible,  in  the  open  air.    The  bottoms 


826  REPORTS   OF   THE   PRESIDENT'S   HOMES   COMMISSION. 

in  the  different  boxes,  instead  of  being  fiat  and  square  cornered,  and  covered 
with  paper,  should  be  slightly  concave  at  the  bottom,  with  the  corners  rounded 
somewhat  like  a  cash  till,  the  idea  being  to  keep  the  dust  from  lodging  in  the 
corners,  where  it  is  difficult  to  remove  even  with  a  bellows.  In  cases  con- 
structed in  this  manner  the  dust  is,  by  its  own  weight,  constantly  working  its 
way  toward  the  center  of  each  box,  where  it  can  easily  be  removed. 

A  practical  method  of  removing  the  caked  dust  is  in  vogue  in  the  Govern- 
ment Printing  Office  at  Washington.  The  type  forms  after  leaving  the  electro- 
type foundry  are  placed  on  a  raised  rack  which  drains  into  a  shallow  tank 
some  6  inches  in  depth,  a  pipe  connecting  this  with  a  sewer.  The  forms  are 
placed  in  a  horizontal  position — that  is  to  say,  the  side  of  the  chase  rests  on 
the  rack.  Steam  under  pressure  is  conducted  by  a  rubber  hose  and  the  face  of 
the  type  is  thoroughly  "  blown,"  as  is  the  reverse  of  the  form.  Later,  when  the 
This  chamber  consists  of  a  zinc-lined  box  about  6  feet  in  length,  4  feet  wide, 
and  4  feet  high,  a  trapdoor  opening  from  the  top  being  the  only  opening.  In 
the  bottom  is  placed  a  coil  of  steam  pipe  which  covers  the  entire  floor  of  the 
box,  one  end  of  the  pipe  being  left  open.  The  pages  of  type  are  placed  on  shallow 
perforated  trays  somewhat  like  a  "  galley,"  each  tray  fitting  in  a  copper  rack, 
consisting  simply  of  two  loops  of  copper,  somewhat  like  an  inverted  U,  with 
pins  attached  on  which  the  trays  set.  Each  rack  holds  eight  pages,  or  a  "  sig- 
nature," on  the  eight  trays.  After  the  box  is  filled,  steam  is  turned  on  and  the 
type  is  thoroughly  boiled  for  an  hour  or  more.  The  pages  are  lifted  in  and  out 
by  means  of  hooks.  This  method  not  only  removes  the  graphite  but  disinte- 
grates the  type  and  "  loosens  "  it,  permitting  easy  distribution.  It  also  leaves 
the  type  very  clean  and  aseptic,  lessening  the  chances  of  infection  by  the  ab- 
sence of  germs.  The  method  of  letting  cold  water  run  on  the  forms  and  thus 
cleansing  them  is  not  so  thorough,  because  the  graphite  "  cakes  "  and  clings 
to  the  type  and  the  dust  is  thrown  into  the  compositor's  case  with  the  type, 
making  the  cases  very  dusty  and  dirty.  Each  compositor  should  supply  himself 
with  a  small  brush,  suitable  for  the  hands,  to  be  used  each  time  he  washes. 
A  private  drinking  cup  is  desirable. 

In  acute  cases  of  lead  poisoning  the  treatment  consists  in  the  administration 
of  alkaline  carbonates,  soap,  soluble  sulphates,  sodium  chloride,  etc.,  washing 
out  the  stomach  with  large  drafts  of  water,  etc.  Alum  has  been  given,  and  at 
one  time  was  considered  almost  a  specific.  Sweet  oil  and  castor  oil  will  be 
found  useful.  Milk  should  be  taken  in  large  quantities.  The  idea  is  first  to 
combat  the  symptoms  and  then  eliminate  the  lead.  Opium  can  be  given  for 
pain.  Warm  sulphureted  baths  are  very  beneficial.  They  can  be  made  by 
dissolving  4  ounces  of  potassium  sulphide  in  30  gallons  of  water  in  a  wooden 
tub.  These  baths  discolor  the  skin,  from  the  formation  of  lead  sulphide,  and 
should  be  repeated  every  few  days  until  this  effect  ceases.  During  each  bath 
the  patient  should  be  well  washed  with  soap  and  water  to  remove  discoloration. 

The  various  kinds  of  typesetting  machines  all  have  a  melting  pot  attached 
to  each  machine,  and  where  many  are  in  use,  unless  there  is  plenty  of  pure 
air  constantly  entering  the  room  and  perfect  ventilation  provided,  the  fumes 
from  each  pot  should  be  conducted  by  pipes  to  a  chamber  in  which  a  vacuum  is 
present,  so  that  the  fumes  may  be  instantly  removed  and  carried  out  into  the 
atmosphere.  The  virtue  of  the  machine  lies  in  the  fact,  so  far  as  health  is 
concerned,  in  the  absence  of  dust,  and  with  the  additional  advantage  on  the 
part  of  the  operator  that  he  does  not  lay  himself  open  to  exposure  in  handling 
the  metal  to  so  great  a  degree  as  in  the  case  of  the  hand  compositor. 

There  are  other  alloys  that  would  take  the  place  of  lead  in  type  metal,  but 
owing  to  the  excessive  cost  and  high  fusing  point  their  use  is  not  practical. 


DOCTOB  manning's   METHOD  FOB  THE   COLLECTION,  DISINFECTION,   AND  DISPOSAL   OF 

SPUTA. 

From  a  sanitary  point  of  view  the  collection,  cleaning,  and  disinfection  of 
the  spittoons  in  the  Government  Printing  Office  is  a  matter  of  considerable 
importance.  This  will  be  readily  understood  when  it  is  remembered  that  there 
are  over  4,300  persons  oujrnirod  during  the  twenty-four  liours,  all  working  in 
eight-hour  shifts,  and  ilmt  no  fewer  than  1,200  cuspidors  must  be  cleaned  at 
the  end  of  each  shift. 

The  method  now  Installed  under  Doctor  Manning's  direction  effects  this  with- 
out direct  digital  contact.  It  consists  in  a  central  sterilizing  chamber  situated 
in  the  basement  of  the  Printing  Office,  with  a  cement  floor,  graded  toward  the 


REPORTS    OF    THE   PRESIDENT'S   HOMES   COMMISSION.  327 

center  and  made  up  of  two  inclines.  All  edges,  angles,  corners,  and  returns  of 
tho  floor  are  well  rounded  and  the  base  of  each  of  the  four  walls  have  6-inch 
"  sanitary  bases  "  in  order  that  all  parts  of  the  room  may  be  self  cleansing  and 
draining.  The  walls  of  the  sterilizing  chamber  are  composed  of  white,  glazed, 
vitrified   brick. 

The  cuspidors  are  collected  by  means  of  a  specially  designed  sanitary  clutch 
which  picks  up  the  cuspidors  in  an  automatic  manner,  one  above  the  other,  in 
"  uests "  of  five,  without  the  janitor  or  cleaner  in  any  manner  touching  his 
person  or  in  any  way  coming  in  contact  with  the  infected  or  soiled  cuspidors, 
avoiding  entirely  the  irksome,  repulsive  features  which  characterize •  the  meth- 
ods in  vogue  at  the  present  time  as  concerns  the  washing  of  spittoons,  and 
greatly  minimizes  the  danger  of  contraction  of  tuberculosis  by  all  concerned, 
and  serves,  in  addition,  to  draw  attention  and  illustrate  a  lesson  in  hygiene  to 
the  unthinking  and  careless. 

The  vessels  thus  collected  are  carried  by  means  of  the  clutch  or  holder  to 
specially  designed  wooden,  zinc-lined  box  trucks  with  detachable  sides.  Each 
truck  is  capable  of  holding  175  cuspidors  for  transmission  to  the  sterilizing 
chamber.  As  5  soiled  cuspidors  are  taken  to  the  truck  they  are  replaced  by 
5  sterilized  cuspidors  picked  up  and  distributed  by  the  same  mechanism,  all 
of  which  is  accomplished  by  the  use  of  one  hand  only  of  the  operator.  After 
the  trucks  are  filled  they  are  transmitted  from  the  respective  floors  to  the 
basement  on  a  freight  elevator  and  wheeled  directly  into  the  sterilizing 
chamber. 

In  the  chamber  is  fitted  up  an  iron  rack  similar  in  form  to  that  shown  in 
photograph  taken  of  Government  Printing  Office  exhibit  at  the  International 
Congress  on  Tuberculosis,  and  is  constructed  of  strips  of  1-inch  angle  iron, 
from  which  hang  suspended  at  intervals  of  10  inches  steel- wire  clutches,  shaped 
somewhat  like  an  inverted  letter  U,  into  which  are  thrust  the  cuspidors  after 
they  have  been  dipped  and  washed  in  boiling  water  (212°  F.),  and  from  whence 
they  are  taken  after  they  have  been  drained  or  dried,  and  replaced  in  trucks 
for  transmission  back  to  the  floors  of  building. 

A  galvanized-iron  trough,  connected  directly  with  the  sewer,  is  placed  at 
the  base  and  in  front  of  the  iron  rack.  The  hot,  boiling  water  is  piped  directly 
into  this  trough  after  it  has  been  heated  for  this  purpose  by  jets  of  steam 
entering  the  pipe  through  which  the  cold  water  flows. 

The  contents  of  cuspidors  are  emptied  directly  into  the  trough  by  means  of 
short  forceps  which  grasp  the  lip  of  the  cuspidor,  whence  it  escapes  to  the 
sewer.  After  the  vessel  has  been  made  thoroughly  clean  and  sterilized  by 
immersion  in  the  boiling  water,  the  operator,  still  grasping  the  forceps,  presses 
the  vessel  into  the  steel  spring  clutch  on  rack,  where  it  drains  and  dries,  as 
shown  in  photograph. 

After  the  cuspidors  have  all  been  washed  and  sterilized  in  the  manner 
described,  they  are  quickly  removed  from  the  spring  clutch  on  iron  rack  by 
the  cleaner  and  replaced  in  truck.  As  each  layer  is  laid  down  in  the  truck, 
from  2  to  4  ounces  of  a  solution  made  up  of  bichloride  of  mercury  7.3  grains; 
citric  acid,  7.7  grains  to  each  gallon  of  water,  which,  in  addition,  is  colored 
with  eosin  to  differentiate  the  solution  and  to  warn  persons  that  the  liquid  is 
not  water,  is  poured  into  each  spittoon,  where  it  remains  until  all  the  vessels  are 
washed  again.  This  gives  a  strength  solution  suflicient  to  kill  the  most  resistant 
disease  germs,  yet  when  still  further  diluted  with  water  in  the  trough  during 
the  cleaning  process,  renders  the  solution  harmless  to  plumbing  work  or  the 
piping  of  sewers. 

The  bichloride  is  used  for  its  germicidal  power,  while  the  citric  acid  is 
added  to  retard  the  coagulation  of  the  albumin  in  the  saliva  and  expectorations, 
and  thus  render  the  action  of  the  bichloride  of  mercury  more  potent.  It  is  one 
of  the  most  powerful  antiseptics  known  to  science. 

The  entire  cost  of  the  chemical  disinfectants  named  amounts  to  less  than 
$12  per  annum.     Five  gallons  can  be  made  for  about  1  penny. 

The  cuspidors  are  specially  designed  to  permit  of  easy  cleaning  and  self- 
draining,  largely  on  account  of  the  character  of  the  curves  employed.  Angles 
which  would  interfere  with  the  cleaning  process  have  been  avoided,  and  the 
stream  of  water  will  readily  reach  all  the  internal  surfaces.  The  constriction, 
or  neck,  is  sufficiently  wide  to  permit  the  stream  of  the  hose  to  enter  with 
full  force.  A  certain  amount  of  constriction  at  the  neck  seemed  desirable 
to  hide  the  contents  of  cuspidor  when  in  use.  They  were  designed,  however, 
with  the  special  object  of  easy  cleaning  and  without  direct  digital  contact, 
because  it  would  seem  almost  inhuman  to  ask  a  cleaner  to  place  his  hand, 


328  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

containing  even  a  sponge,  in  the  ordinary  stock  cuspidor  and  wash  the  interior 
in  a  thorough  and  sanitary  manner.  All  of  this  repulsive  work  has  been 
avoided,  so  that  by  the  new  method  the  operator  does  not  touch  the  cuspidor 
with  his  hands  until  he  plucks  the  washed  and  sterilized  cuspidor  from  the  rack 
and  places  it  in  the  truck. 

Hard  vitrified  china  ware  has  been  used  to  construct  the  cuspidors,  as  this 
is  the  only  material  that  will  withstand  the  corrosive  action  of  bichloride  of 
mercury  and  at  the  same  time  present  a  smooth,  white  surface  for  sanitary 
cleansing. 

Approximately  about  3,800  barrels  of  sawdust  are  used  each  year  for  cus- 
pidors in  the  Government  Printing  Office,  at  a  cost  of  about  $100  per  month. 
While,  of  course,  this  item  will  be  saved,  together  with  the  cost  of  handling 
and  carting  away  of  the  foul  and  polluted  sawdust,  the  main  object  has  been 
to  reduce  to  a  minimum  the  danger  of  infection  through  tuberculosis  sputa 
among  the  employees." 


•  *  •  *  * 

The  report  of  Doctor  Manning,  in  charge  of  the  sanitary  division  of  the 
Government  Printing  Office,  shows  that  of  4,556  employees  in  the  building  from 
January  1,  1906,  to  February  29,  1908,  1,153  employees  received  treatment  at 
the  emergency  room,  595  were  medical  cases  inclusive  of  9  cases  of  lead  colic. 
Of  these,  516  resumed  work,  76  were  sent  home  for  treatment,  and  3  died.  Of 
the  558  surgical  cases,  517  resumed  work  and  41  were  sent  home  for  treat- 
ment. The  emergency  department  is  well  equipped,  and  the  results  have  in 
every  way  justified  its  establishment. 


!Ajppendix  B. 

EEGTJLATION  OF  DANGEROUS  TRADES  IN  ENGLAND. 

In  addition  to  the  general  provisions  regarding  ventilation,  etc.,  which  apply 
to  all  manufacturing  establishments,  the  English  factory  and  workshop  act 
.(1901)  contains  a  chapter  of  special  provisions  for  dangerous  and  unhealthy 
industries,  which  is  reprinted  below,  together  with  the  special  rules  and  regu- 
lations issued  by  the  government  officials  in  accordance  with  the  grant  of 
authority  therein  made. 

FACTORY  AND  WORKSHOP  ACT,  1901. 

Past  IV. — Dangerous  and  Unhealthy  Industries, 

(i)    SPECIAL  PROVISIONS. 

SECTioif  73.  (1)  Every  medical  practitioner  attending  on  or  called  in  to  vl«it 
a  patient  whom  he  believes  to  be  suffering  from  lead,  phosphorus,  arsenical, 
or  mercurial  poisoning,  or  anthrax,  contracted  in  any  factory  or  workshop, 
shall  (unless  the  notice  required  by  this  subsection  has  been  previously  sent) 
send  to  the  chief  inspector  of  factories  at  the  home  office,  London,  a  notice 
stating  the  name  and  full  postal  address  of  the  patient  and  the  disease  from 
which,  in  the  opinion  of  the  medical  practitioner,  the  patient  is  suffering,  and 
shall  be  entitled  in  respect  of  every  notice  sent  in  pursuance  of  this  section  to 
a  fee  of  2  shillings  and  6  pence,  to  be  paid  as  part  of  the  expenses  incurred  by 
the  secretary  of  state  in  the  execution  of  this  act. 

(2)  If  any  medical  practitioner,  when  required  by  this  section  to  send  a 
notice,  fails  forthwith  to  send  the  name,  he  shall  be  liable  to  a  fine  not  ex- 
ceeding 40  shillings. 

«  All  of  the  mechanical  devices  used  in  the  above  method  have  been  designed 
by  Doctor  Manning,  and  were  awarded  a  special  gold  medal  by  the  Interna- 
tional Congress  on  Tuberculosis,  1908. 


EEPORTS   OF   THE  PEESIDENT 's  HOMES   COMMISSION.  329 

(3)  Written  notice  of  every  case  of  lead,  phosphorus,  arsenical,  or  mercurial 
poisoning,  or  anthrax,  occurring  in  a  factory  or  workshop  shall  forthwith  be 
sent  to  the  inspector  and  to  the  certifying  surgeon  for  the  district ;  and  the  pro- 
visions of  this  act  with  respect  to  accidents  shall  apply  to  any  such  case  in  like 
manner  as  to  any  such  accident  as  is  mentioned  in  those  provisions. 

(4)  The  secretary  of  state  may,  by  special  order,  apply  the  provisions  of  this 
section  to  any  other  disease  occurring  in  a  factory  or  workshop,  and  thereupon 
this  section  and  the  provisions  referred  to  therein  shall  apply  accordingly. 

Sec.  74.  If  in  a  factory  or  workshop  where  grinding,  glazing,  or  polishing  on 
a  wheel,  or  any  process  is  carried  on  by  which  dust,  or  any  gas,  vapor,  or  other 
impurity,  is  generated  and  inhaled  by  the  workers  to  an  injurious  extent,  it 
appears  to  an  inspector  that  such  inhalation  could  be  to  a  great  extent  pre- 
vented by  the  use  of  a  fan  or  other  mechanical  means,  the  inspector  may  direct 
that  a  fan  or  other  mechanical  means  of  a  proper  construction  for  preventing 
such  inhalation  be  provided  within  a  reasonable  time,  and  if  the  same  is  not 
provided,  maintained,  and  used,  the  factory  or  workshop  shall  be  deemed  not 
to  be  kept  in  conformity  with  this  act. 

Sec.  75.  (1)  In  every  factory  or  workshop  where  lead,  arsenic,  or  any  other 
poisonous  substance  is  used,  suitable  washing  conveniences  must  be  provided  for 
the  use  of  the  persons  employed  in  any  department  where  such  substances  are 
used. 

(2)  In  any  factory  or  workshop  where  lead,  arsenic,  or  other  poisonous  sub- 
stance is  so  used  as  to  give  rise  to  dust  or  fumes,  a  person  shall  not  be  allowed 
to  take  a  meal  or  to  remain  during  the  times  allowed  for  him  for  meals  in  any 
room  in  which  any  such  substance  is  used,  and  suitable  provision  shall  be  made 
for  enabling  the  persons  employed  in  such  rooms  to  take  their  meals  elsewhere 
in  the  factory  or  workshop. 

(3)  A  factory  or  workshop  in  which  there  is  a  contravention  of  this  section 
shall  be  deemed  not  to  be  kept  in  conformity  with  this  act. 

Sec.  76.  (1)  A  woman,  young  person,  or  child  must  not  be  employed  in  any 
part  of  a  factory  in  which  wet  spinning  is  carried  on  unless  sufficient  means  are 
employed  and  continued  for  protecting  the  workers  from  being  wetted,  and 
where  hot  water  is  used  for  preventing  the  escape  of  steam  into  the  room  occu- 
pied by  the  workers. 

(2)  A  factory  in  which  there  is  a  contravention  of  this  section  shall  be 
deemed  not  to  be  kept  in  conformity  with  this  act. 

Sec.  77.  (1)  In  the  part  of  a  factory  or  workshop  in  which  there  is  carried 
on  (a)  the  process  of  silvering  of  mirrors  by  the  mercurial  process,  or  (?))  the 
process  of  making  white  lead,  a  young  person  or  child  must  not  be  employed. 

(2)  In  the  part  of  a  factory  in  which  the  process  of  melting  or  annealing 
glass  is  carried  on  a  female,  young  person,  or  a  child  must  not  be  employed. 

(3)  In  a  factory  or  workshop  in  which  there  is  carried  on  (a)  the  making 
or  finishing  of  bricks  or  tiles  not  being  ornamental  tiles,  or  (&)  the  making  or 
finishing  of  salt,  a  girl  under  the  age  of  16  years  must  not  be  employed. 

(4)  In  the  part  of  a  factory  or  workshop  in  which  there  is  carried  on 
(a)  any  dry  grinding  in  the  metal  trade,  or  (6)  the  dipping  of  lucifer  matches, 
a  child  must  not  be  employed. 

(5)  Notice  of  a  prohibition  contained  in  this  section  must  be  affixed  in  the 
factory  or  workshop  to  which  it  applies. 

Sec  78.  (1)  A  woman,  young  person,  or  child  must  not  be  allowed  to  take  a 
meal  or  to  remain  during  the  time  allowed  for  meals  in  the  following  factories 
or  workshops,  or  parts  of  factories  or  workshops;  that  is  to  say,  (a)  in  the 
case  of  glass  works  in  any  part  in  which  the  materials  are  mixed;  and  (6)  in 
the  case  of  glass  works  where  flint  glass  is  made,  in  any  part  in  which  the  work 
of  grinding,  cutting,  or  polishing  is  carried  on;  and  (c)  in  the  case  of  lucifer- 
match  works,  in  any  part  of  which  any  manufacturing  process  or  handicraft 
(except  that  of  cutting  the  wood)  is  usually  carried  on;  and  (d)  in  the  case 
of  earthenware  works,  in  any  part  known  or  used  as  dippers'  house,  dippers' 
drying  room,  or  china  scouring  room. 

(2)  If  a  woman,  young  person,  or  child  is  allowed  to  take  a  meal  or  to  remain 
during  the  time  allowed  for  meals  in  a  factory  or  workshop  or  part  thereof  in 
contravention  of  this  section,  the  woman,  young  person,  or  child  shall  be  deemed 
to  be  employed  contrary  to  the  provisions  of  this  act. 

(3)  Notice  of  the  prohibition  of  this  section  shall  be  afl3xed  in  every  factory 
or  workshop  to  which  it  applies. 


330  KEPORTS   OF   THE   PRESIDENT'S   HOMES   COMMISSION. 

(4)  Where  it  appears  °^  to  the  secretary  of  state  that  by  reason  of  the  nature 
of  the  process  in  any  class  of  factories  or  workshops  or  parts  thereof  not  named 
in  this  section  the  taking  of  meals  therein  is  specially  injurious  to  health,  he 
may,  if  he  thinks  fit,  by  special  order  extend  the  prohibition  in  this  section  to 
the  class  of  factories  or  workshops  or  parts  thereof. 

(5)  If  the  prohibition  in  this  section  is  proved  to  the  satisfaction  of  the  sec- 
retary of  state  to  be  no  longer  necessary  for  the  protection  of  the  health  of 
women,  young  persons,  and  children,  in  any  class  of  factories  or  workshops  or 
parts  thereof  to  w^hich  it  has  been  so  extended,  he  may,  by  special  order,  rescind 
the  order  of  extension,  without  prejudice  to  the  subsequent  making  of  another 
order. 

(it)    REGULATIONS    FOR   DANGEROUS    TRADES. 

Sec.  79.  Where  the  secretary  of  state  is  satisfied  that  any  manufacture, 
machinery,  plant,  process,  or  description  of  manual  labor,  used  in  factories  or 
workshops,  is  dangerous  or  injurious  to  health  or  dangerous  to  life  or  limb, 
either  generally  or  in  the  case  of  women,  children,  or  any  other  class  of  persons, 
he  may  certify  that  manufacture,  machinery,  plant,  process,  or  description  of 
manual  labor  to  be  dangerous :  and  thereupon  the  secretary  of  state  may,  sub- 
ject to  the  provisions  of  this  act,  make  such  regulations  as  appear  to  him  to  be 
reasonably  practicable  and  to  meet  the  necessity  of  the  case. 

Sec.  80.  (1)  Before  the  secretary  of  state  makes  any  regulations  under  this 
act,  he  shall  publish,  in  such  manner  as  he  may  think  best  adapted  for  inform- 
ing persons  affected,  notice  of  the  proposal  to  make  the  regulations,  and  of  the 
place  where  copies  of  the  draft  regulations  may  be  obtained,  and  of  the  time 
(which  shall  not  be  less  than  twenty-one  days)  within  which  any  objection 
made  with  respect  to  the  draft  regulations  by  or  on  behalf  of  persons  affected 
must  be  sent  to  the  secretary  of  state. 

(2)  Every  objection  must  be  in  writing  and  state — (a)  the  draft  regulations 
or  portions  of  draft  regulations  objected  to,  (ft)  the  specific  grounds  of  ob- 
jection, and  (c)  the  omissions,  additions,  or  modifications  asked  for. 

(3)  The  secretary  of  state  shall  consider  any  objection  made  by  or  on  be- 
half of  any  persons  appearing  to  him  to  be  aifected  which  is  sent  to  him  vrithin 
the  required  time,  and  he  may,  if  he  thinks  fit,  amend  the  draft  regulations, 
and  shall  then  cause  the  amended  draft  to  be  dealt  with  in  like  manner  as  an 
original  draft. 

(4)  Where  the  secretary  of  state  does  not  amend  or  withdraw  any  draft 
I'cgulations  to  which  any  objection  has  been  made,  then  (unless  the  objection 
eitlior  is  withdrawn  or  appears  to  him  to  be  frivolous)  he  shall,  before  making 
the  regulations,  direct  an  inquiry  to  be  held  in  the  manner  hereinafter  provided. 

Sec.  81.  (1)  The  secretary  of  state  may  appoint  a  competent  person  to  hold 
an  inquiry  with  regard  to  any  draft  regulations,  and  to  report  to  him  thereon. 

(2)  The  inquiry  shall  be  held  in  public,  and  the  chief  inspector  and  any  ob- 
jector and  any  other  person  who,  in  the  opinion  of  the  person  holding  the  in- 
quiry, is  affected  by  the  draft  regulations,  may  appear  at  the  inquiry  either  in 
person  or  by  counsel,  solicitor,  or  agent. 

(3)  The  witnesses  on  the  inquiry  may,  if  the  person  holding  it  thinks  fit,  be 
examined  on  oath. 

(4)  Subject  as  aforesaid,  the  inquiry  and  all  proceedings  preliminary  and 
incidental  thereto  shall  be  conducted  in  accordance  with  rules  made  by  the 
secretary  of  state. 

(5)  The  fee  to  be  paid  to  the  person  holding  the  inquiry  shall  be  such  as  the 
secretary  of  state  may  direct  and  shall  be  deemed  to  be  part  of  the  expenses  of 
the  secretary  of  state  in  the  execution  of  this  act. 

Sec.  82.  (1)  The  regulations  made  under  the  foregoing  provisions  of  this 
act  may  apply  to  all  the  factories  and  workshops  in  which  the  manufacture, 
machinery,  plant,  process,  or  description  of  manual  labor  certified  to  be  dan- 
gerous is  used  (whether  existing  at  the  time  when  the  roirulations  are  made  or 
afterwards  established),  or  to  any  specified  class  of  such  fnctorios  or  work- 
shop. They  may  provide  for  the  exemption  of  any  specified  class  or  factories 
or  workshops  either  absolutely  or  subject  to  conditions. 

(2)  The  regulations  may  apply  to  tenement  factories  and  tenement  work- 
shops, and  in  such  case  may  impose  duties  on  occupiers  who  do  not  employ 
any  person,  and  on  owners. 

<»For  orders  extending  the  prohibition  in  this  section,  see  post. 


REPOETS    OF    THE   PRESIDENT'S   HOMES   COMMISSION.  331 

(3)  No  person  shall  be  precluded  by  any  agreement  from  doing,  or  be  liable 
under  any  agreement  to  any  penalty  or  forfeiture  for  doing,  such  acts  as  may 
be  necessary  in  order  to  comply  with  the  provisions  of  any  regulation  made 
under  this  act. 

Sec.  S3.  Regulations  made  under  the  foregoing  provisions  of  this  act  may, 
siniong  other  things — (a)  prohibit  the  employment  of,  or  modify  or  limit  the 
period  of  employment  of,  all  persons  or  any  class  of  persons  in  any  manufacture, 
machinery,  plant,  process,  or  description  of  manual  labor  certified  to  be  danger- 
ous, and  (6)  prohibit,  limit,  or  control  the  use  of  any  material  or  process,  and 
(c)  modify  or  extend  any  special  regulations  for  any  class  of  factories  or 
workshops  contained  in  this  act. 

Sec.  84.  Regulations  made  under  the  foregoing  provisions  of  this  act  shall 
be  laid  as  soon  as  possible  before  both  houses  of  Parliament,  and  if  either 
house  within  the  next  forty  days  after  the  regulations  have  been  laid  before  the 
house,  resolve  that  all  or  any  of  the  regulations  ought  to  be  annulled,  the  regu- 
lations shall,  after  the  date  of  resolution,  be  of  no  effect,  without  prejudice  to 
the  validity  of  anything  done  in  the  meantime  thereunder  or  to  the  making  of 
any  new  regulations.  If  one  or  more  of  a  set  of  regulations  are  annulled,  the 
secretary  of  state  may,  if  he  thinks  fit,  withdraw  the  whole  set. 

Sec.  85.  (1)  If  any  occupier,  owner,  or  manager,  who  is  bound  to  observe  any 
regulation  under  this  act,  acts  in  contravention  of  or  fails  to  comply  with  the 
regulation,  he  shall  be  liable  for  each  offense  to  a  fine  not  exceedhig  £10  ($48.67) 
and,  in  the  case  of  a  continuing  offense,  to  a  fine  not  exceeding  £2  ($9.73)  for 
every  day  during  which  the  offense  continues  after  conviction  therefor. 

(2)  If  any  person  other  than  an  occupier,  owner,  or  manager,  who  is  bound 
to  observe  any  regulation  under  jthis  act,  acts  in  contravention  of  or  fails  to 
comply  with  the  regulation,  he  shall  be  liable  for  each  offense  to  a  fine  not 
exceeding  £2  ($9.73)  and  the  occupier  of  the  factory  or  workshop  shall  also  be 
liable  to  a  fine  not  exceeding  £10  ($48.67),  unless  he  proves  that  he  has  taken 
all  reasonable  means  by  publishing,  and  to  the  best  of  his  power  enforcing,  the 
regulations  to  prevent  the  contravention  or  noncompliance. 

Sec.  86.  (1)  Notice  of  any  regulations  having  been  made  under  the  foregoing 
provisions  of  this  act,  and  of  the  place  where  copies  of  them  can  be  purchased, 
shall  be  published  in  the  London,  Edinburgh,  and  Dublin  Gazettes. 

(2)  Printed  copies  of  all  regulations  for  the  time  being  in  force  under  this 
act  in  any  factory  or  workshop  shall  be  kept  posted  up  in  legible  characters  in 
conspicuous  places  in  the  factory  or  workshop  where  they  may  be  conveniently 
rend  by  the  persons  employed.  In  a  factory  or  workshop  in  Wales  or  Mon- 
mouthshire the  regulations  shall  be  posted  up  in  the  Welsh  language  also. 

(3)  A  printed  copy  of  all  such  regulations  shall  be  given  by  the  occupier  to 
any  person  affected  thereby  on  his  or  her  application. 

(4)  If  the  occupier  of  any  factory  or  workshop  fails  to  comply  with  any  pro- 
vision of  this  section  as  to  posting  up  or  giving  copies,  he  shall  be  liable  to  a 
fine  not  exceeding  £10  (49.67). 

(5)  Every  person  who  pulls  down,  injures,  or  defaces  any  regulation  posted 
up  in  pursuance  of  this  act,  or  any  notice  posted  up  in  pursuance  of  the  regula- 
tions, shall  be  liable  to  a  fine  not  exceeding  £5  ($24. .So). 

(6)  Regulations  for  the  time  being  in  force  under  this  act  shall  be  judicially 
noticed. 


Special  rules  and  regulations* 

White  lead  factories. 

Red  and  orange  lead  works. 

Yellow  lead  works. 

Lead  smelting  works. 

Factories  using  yellow  chromate  of  lead. 

Earthenware  and  china  works. 

Electric   accumulator   factories    (regulations). 

Iron-plate  enameling  works  (using  lead,  arsenic,  or  antimony), 

Tinning  and  enameling  works  (using  lead  or  arsenic). 

Paint  and  color  works  (extractions  of  arsenic). 

Brass  and  compound  metal  mixing  or  casting  shops. 

Chemical  works. 

Bichromate  or  chromate  of  potassium  or  sodium  works. 

Explosive  works  (using  di-nitro-benzole) . 


332  EEPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

Vulcanized  india-rubber  works  (using  bisulphide  of  carbon). 

Lucifer  match  factories  using  white  or  yellow  phosphorus. 

Felt-hat  factories  (regulations). 

Handling  of  dry  and  dry-salted  hides  and  skins  imported  from  Asia. 

Wool  and  hair  sorting  (regulations). 

Flax  and  tow  spinning  and  weaving  (regulations). 

File  cutting  by  hand  (regulations). 

Bottling  of  aerated  water. 

Spinning  by  self-acting  mules  (regulations).^ 

Loading  goods  on  docks  and  wharves  (regulations). 

Use  of  factory  engines  and  cars  (regulations). 

White-Lead  Factories. 
[Form  247 — February,  1903.] 

In  these  rules  "  persons  employed  in  a  lead  process  "  means  a  person  who  is 
employed  in  any  work  or  process  involving  exposure  to  white  lead,  or  to  lead  or 
lead  compounds  used  in  its  manufacture,  or  who  is  admitted  to  any  room  or 
part  of  the  factory  where  such  process  is  carried  on. 

Any  approval  given  by  the  chief  inspector  of  factories  in  pursuance  of  rules 
2,  4,  6,  9,  or  12  shall  be  given  in  writing,  and  may  at  any  time  be  revoked  by 
notice  in  writing  signed  by  him. 

DUTIES   OF  OCCUPIERS. 

1.  On  and  after  July  1,  1899,  no  part  of  a  white-lead  factory  shall  be  con- 
structed, structurally  altered,  or  newly  used,  for  any  process  in  which  white 
lead  is  manufactured  or  prepared  for  sale,  unless  the  plans  have  previously 
been  submitted  to  and  approved  in  writing  by  the  chief  inspector  of  factories. 

2.  (a)  Every  stack  shall  be  provided  with  a  standpipe  and  movable  hose,  and 
an  adequate  supply  of  water  distributed  by  a  hose. 

(&)  Every  white  bed  shall,  on  the  removal  of  the  covering  boards,  be  effect- 
ually damped  by  the  means  mentioned  above. 

Where  it  is  shown  to  the  satisfaction  of  the  chief  inspector  of  factories  that 
there  is  no  available  public  water  service  in  the  district,  it  shall  be  a  suflSicient 
compliance  with  this  rule  if  each  white  bed  is,  on  the  removal  of  the  covering 
boards,  effectually  damped  by  means  of  a  watering  can. 

3.  Where  white  lead  is  made  by  the  chamber  process,  the  chamber  shall  be 
kept  moist  while  the  process  is  in  operation,  and  the  corrosions  shall  be  effect- 
ually moistened  before  the  chamber  is  emptied. 

4.  (a)  Corrosions  shall  not  be  carried  except  in  trays  of  impervious  material, 
(6)  No  person  shall  be  allowed  to  carry  on  his  head  or  shoulder  a  tray  of 

corrosions  which  has  been  allowed  to  rest  directly  upon  the  corrosions,  or  upon 
any  surface  where  there  is  white  lead. 

(c)  All  corrosions  before  being  put  into  the  rollers  or  wash  becks  shall  be 
effectually  damped,  either  by  dipping  the  tray  containing  them  in  a  trough  of 
water  or  by  some  other  method  approved  by  the  chief  inspector  of  factories. 

6.  The  flooring  around  the  rollers  shall  either  be  of  smooth  cement  or  be  cov- 
ered with  sheet  lead,  and  shall  be  kept  constantly  moist. 

6.  On  and  after  January  1,  1901,  except  as  hereinafter  provided — 

(o)  Every  stove  shall  have  a  window,  or  windows,  with  a  total  area  of  not 
less  than  8  square  feet,  made  to  open,  and  so  placed  as  to  admit  of  effectual 
through  ventilation. 

(6)  In  no  stove  shall  bowls  be  placed  on  a  rack  which  is  more  than  10  feet 
from  the  floor. 

(c)  Each  bowl  shall  rest  upon  the  rack  and  not  upon  another  bowl. 

(d)  No  stove  shall  be  entered  for  the  purpose  of  drawing  until  the  temper- 
ature at  a  height  of  5  feet  from  the  floor  has  fallen  either  to  70°  F.,  or  to  a 
point  not  more  than  10*  F.  above  the  temperature  of  the  air  outside. 

(e)  In  drawing  any  stove  or  part  of  a  stove  there  shall  not  be  more  than  one 
stage  or  standing  place  above  the  level  of  the  floor. 

Provided  that  if  the  chief  insi)ector  approves  of  any  other  means  of  ventilat- 
ing a  stove,  as  allowing  of  effectual  through  ventilation,  such  means  may  be 
adopted,  notwithstanding  paragraph  (a)  of  this  rule;  and  if  he  approves  of  any 
other  method  of  setting  and  drawing  the  stoves,  as  ellectually  preventing  white 


EEPORTS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  333 

lead  from  falling  upon  any  worker,  such  method  may  be  followed,  notwith- 
standing paragraphs  (6)  and  (e)  of  this  rule. 

7.  No  person  shall  be  employed  in  drawing  Dutch  stoves  on  more  than  two 
days  in  any  week. 

8.  No  dry  white  lead  shall  be  deposited  in  any  place  that  is  not  provided 
either  with  a  cover  or  with  a  fan  effectually  removing  the  dust  from  the  worker. 

9.  On  and  after  January  1,  1900,  the  packing  of  dry  white  lead  shall  be  done 
only  under  conditions  which  secure  the  effectual  removal  of  dust,  either  by 
exhaust  fans  or  by  other  efficient  means  approved  in  each  case  by  the  chief 
inspector  of  factories. 

This  rule  shall  not  apply  where  the  packing  is  effected  by  mechanical  means 
entirely  closed  in. 

10.  The  floor  of  any  place  where  packing  of  dry  white  lead  is  carried  on  shall 
be  of  cement,  or  of  stone  set  in  cement. 

11.  No  woman  shall  be  employed  or  allowed  in  the  white  beds,  rollers  wash 
becks,  or  stoves,  or  in  any  place  where  dry  white  lead  is  packed,  or  in  other 
work  exposing  her  to  white  lead  dust. 

12.  (a)  A  duly  qualified  medical  practitioner  (in  these  rules  referred  to  as 
the  "appointed  surgeon")  shall  be  appointed  by  the  occupier  for  each  factory, 
such  appointment  to  be  subject  to  the  approval  of  the  chief  inspector. 

(6)  No  person  shall  be  employed  in  a  lead  process  for  more  than  a  week 
without  a  certificate  of  fitness  granted  after  examination  by  the  appointed 
surgeon. 

(c)  Every  person  employed  in  a  lead  process  shall  be  examined  once  a  week 
by  the  appointed  surgeon,  who  shall  have  power  to  order  suspension  from 
employment  in  any  place  or  process. 

(d)  No  person  after  such  suspension  shall  be  employed  in  a  lead  process 
without  the  written  sanction  of  the  appointed  surgeon. 

(e)  A  register  in  a  form  approved  by  the  chief  inspector  of  factories  shall  be 
kept,  and  shall  contain  a  list  of  all  persons  employed  in  lead  processes.  The 
appointed  surgeon  will  enter  in  the  register  the  dates  and  results  of  his  exam- 
inations of  the  persons  employed,  and  particulars  of  any  directions  given  by 
him.  The  register  shall  be  produced  at  any  time  when  required  by  His 
Majesty's  inspectors  of  factories  or  by  the  certifying  surgeon  or  by  the 
appointed  surgeon. 

13.  Upon  any  person  employed  in  a  lead  process  complaining  of  being  unwell, 
the  occupier  shall,  with  the  least  possible  delay,  give  an  order  upon  a  duly 
qualified  medical  practitioner. 

14.  The  occupier  shall  provide  and  maintain  sufficient  and  suitable  respirators, 
overalls,  and  head  coverings,  and  shall  cause  them  to  be  worn  as  directed  in 
rule  29. 

At  the  end  of  every  day's  work  they  shall  be  collected  and  kept  in  proper 
custody  in  a  suitable  place  set  apart  for  the  purpose. 

They  shall  be  thoroughly  washed  or  renewed  every  week,  and  those  which 
have  been  used  in  the  stoves,  and  all  respirators,  shall  be  washed  or  renewed 
daily. 

15.  The  occupier  shall  provide  and  maintain  a  dining  room  and  a  cloakroom 
in  which  workers  can  deposit  clothing  put  off  during  working  hours. 

16.  No  person  employed  in  a  lead  process  shall  be  allowed  to  prepare  or 
partake  of  any  food  or  drink  except  in  the  dining  room  or  kitchen. 

17.  A  supply  of  a  suitable  sanitary  drink,  to  be  approved  by  the  appointed 
surgeon,  shall  be  kept  for  the  use  of  the  workers. 

18.  The  occupier  shall  provide  and  maintain  a  lavatory  for  the  use  of  the 
workers,  with  soap,  nailbrushes,  and  at  least  one  lavatory  basin  for  every  five 
persons  employed.  Each  such  basin  shall  be  fitted  with  a  waste  pipe.  There 
shall  be  a  constant  supply  of  hot  and  cold  water  laid  on,  except  where  there 
is  no  available  public  water  service,  in  which  case  the  provision  of  hot  and 
cold  water  shall  be  such  as  shall  satisfy  the  inspector  in  charge  of  the  district. 

The  lavatory  shall  be  thoroughly  cleaned  and  supplied  with  clean  towels  after 
every  meal. 

There  shall,  in  addition,  be  means  of  washing  in  close  proximity  to  the 
workers  of  each  department,  if  required  by  notice  in  writing  from  the- inspector 
in  charge  of  the  district. 

There  shall  be  facilities,  to  the  satisfaction  of  the  inspector  in  charge  of  the 
district,  for  the  workers  to  wash  out  their  mouths. 

19.  Before  each  meal,  and  before  the  end  of  the  day's  work,  at  least  10  min- 
uts  in  addition  to  the  regular  meal  times  shall  be  allowed  to  each  work«*  for 
washing. 


334  REPORTS   OF   THE   PRESIDENT'S   HOMES   COMMISSION. 

A  notice  to  this  effect  shall  be  affixed  in  each  department. 

20.  The  occupier  shall  provide  and  maintain  sufficient  baths  and  dressing 
rooms  for  all  persons  employed  in  lead  processes  with  hot  and  cold  water,  soap, 
and  towels,  and  shall  cause  each  such  person  to  take  a  bath  once  a  week  at  the 
factory. 

A  bath  register  shall  be  kept  containing  a  list  of  all  persons  employed  in  lead 
processes  and  an  entry  of  the  date  when  each  person  takes  a  bath. 

This  register  shall  be  produced  at  any  time  when  required  by  His  Majesty's 
inspectors  of  factories  or  by  the  certifying  surgeon  or  by  the  appointed  surgeon. 

21.  The  dressing  rooms,  baths,  and  water-closets  shall  be  cleaned  daily. 

22.  The  floor  of  each  work  room  shall  be  cleaned  daily,  after  being  thoroughly 
damped. 

DUTIES  OF  PERSONS   EMPLOYED. 

23.  No  person  shall  strip  a  white  bed  or  empty  a  chamber  without  previously 
effectually  damping,  as  directed  in  rules  2  and  3. 

24.  No  person  shall  carry  corrosions  or  put  them  into  the  rollers  or  wash 
becks  otherwise  than  as  permitted  by  rule  4. 

25.  No  person  shall  set  or  draw  a  stove  otherwise  than  as  permitted  by  rules 
6  and  7. 

26.  No  person  shall  deposit  or  pack  dry  white  lead  otherwise  than  as  per- 
mitted by  rules  8  and  9. 

27.  Every  person  employed  in  a  lead  process  shall  present  himself  at  the  ap- 
pointed times  for  examination  by  the  appointed  surgeon,  as  provided  in  rule  22. 

28.  No  person,  after  suspension  by  the  appointed  surgeon,  shall  work  in  a  lead 
process  without  his  written  sanction. 

29.  Every  person  engaged  in  [stripping]  white  beds,  emptying  chambers, 
rollers,  wash  becks,  or  grinding,  setting,  or  dra-wing  stoves,  packing,  paint  mix- 
ing, handling  dry  white  lead,  or  in  any  work  involving  exposure  to  white-lead 
dusts,  shall,  while  so  occupied,  wear  an  overall  suit  and  head  covering. 

Every  person  engaged  in  stripping  white  beds,  or  in  emptying  chambers,  or  in 
drawing  stoves,  or  in  packing,  shall  in  addition  wear  a  respirator  while  so 
occupied. 

30.  Every  person  engaged  in  any  place  or  process  named  in  rule  29  shall,  be- 
fore partaking  of  meals  or  leaving  the  premises,  deposit  the  overalls,  head 
coverings,  and  respirators  in  the  place  appointed  by  the  occupier  for  the  pur- 
pose, and  shall  thoroughly  wash  face  and  hands  in  the  lavatory. 

31.  Every  person  employed  in  a  lead  process  shall  take  a  bath  at  the  factory 
at  lenst  once  a  week,  and  wash  in  the  lavatory  before  bathing;  having  done  so 
he  shall  at  once  sign  his  name  in  the  bath  register,  with  the  date. 

32.  No  person  employed  in  a  lead  process  shall  smoke  or  use  tobacco  in  any 
form  or  partake  of  food  or  drink  elsewhere  than  in  the  dining  room  or  kitchen. 

33.  No  person  shall  in  any  way  interfere,  without  the  knowledge  and  concur- 
rence of  the  occupier  or  manager,  with  the  means  and  appliances  provided  for 
the  removal  of  dust. 

34.  The  foreman  shall  report  to  the  manager,  and  the  manager  shall  report  to 
the  occupier,  any  instance  coming  under  his  notice  of  a  worker  neglecting  to 
observe  these  rules. 

35.  No  person  shall  obtain  employment  under  an  assumed  name  or  under  any 
false  pretense. 

Arthxjb   Whitelegge, 
Chief  Inspector  of  Factories. 
M.  W.  Ridley, 
One  of  His  Majesty's  Principal  Secretaries  of  State. 
1st  June,  1899. 

Note. — These  rules  must  be  kept  posted  up  in  conspicuous  places  in  the  fac- 
tory to  which  they  apply,  where  they  may  be  conveniently  read  by  the  persons 
employed.  Any  person  who  is  bound  to  observe  these  rules  and  fails  to  do  so,  or 
acts  in  contravention  of  them  is  liable  to  a  penalty ;  and  in  such  cases  the  occu- 
pier also  is  liable  to  a  penalty  unless  he  proves  that  he  has  taken  all  reasonable 
means  by  publishing,  and  to  the  best  of  his  power,  enforcing  the  rules,  to  pre- 
vent the  contravention  or  noncompliance.  (Factory  and  workshop  act,  1901, 
sees.  85  and  86.) 


REPORTS    OF    THE  PRESIDENT'S   HOMES   COMMISSION.  335 

Red  and  Orange  Lead  Works. 

[Form  261— February,   1904.] 

DUTIES    OF   OCCUPIERS. 

In  drawing  charges  of  massicot,  or  of  red  lead,  or  of  orange  lead,  from  the 
furnace  they  shall  not  allow  the  charges  of  massicot,  or  of  red  lead,  or  of  orange 
leiid,  to  be  discharged  onto  the  floor  of  the  factory  or  workshop,  but  shall  ar- 
range that  it  be  shoveled,  not  raked,  into  wagons. 

They  shall  arrange  that  no  red  or  orange  lead  shall  be  packed  in  the  room  or 
rooms  where  the  manufacture  is  actually  carried  on. 

They  shall  arrange  that  no  red  or  orange  lead  shall  be  packed  in  casks  or 
other  receptacles  except  in  a  place  provided  with  a  hood  connected  with  a  fan, 
or  shall  provide  other  suitable  means  to  create  an  effective  draft. 

They  shall  provide  sufficient  bath  accommodation  for  all  persons  employed 
in  the  manipulation  of  red  and  orange  lead,  and  lavatories,  with  a  good  supply 
of  hot  water,  soap,  nailbrushes,  and  towels  for  the  use  of  such  persons. 

They  shall  arrange  for  a  monthly  visit  by  a  medical  man  who  shall  examine 
every  worker  individually,  and  who  shall  enter  the  result  of  each  examination 
in  a  register  book  to  be  provided  by  the  said  occupiers. 

They  shall  provide  a  sufficient  supply  of  approved  sanitary  drink  for  the 
workers. 

DUTIES    OF    PERSONS    EMPLOYED. 

In  case  where  the  cooperation  of  the  workers  is  required  for  carrying  out 
the  foregoing  rules,  and  where  such  cooperation  is  not  given,  the  workers  shall 
be  held  liable  in  accordance  with  the  factory  and  workshop  act,  1891,  section 
9,  which  runs  as  follows : 

'*  If  any  person  who  is  bound  to  observe  any  special  rules  established  for  any 
factory  or  workshop  under  this  act,  acts  in  contravention  of,  or  fails  to  comply 
with,  any  such  special  rule,  he  shall  be  liable  on  summary  conviction  to  a  fine 
not  exceeding  £2  ($9.73)." 

Yellow  Lead. 

[Form  263 — February,  1904.] 

DUTIES    OF   occupiers. 

They  shall  provide  washing  conveniences,  with  a  sufficient  supply  of  hot  and 
cold  water,  soap,  nailbrushes,  and  towels. 

They  shall  provide  respirators  and  overall  suits  for  the  persons  employed  in 
all  dry  processes. 

They  shall  provide  fans  or  other  suitable  means  of  ventilation  wherever  dust 
is  generated  in  the  process  of  manufacture. 

They  shall  provide  a  sufficient  supply  of  epsom  salts  and  of  an  approved  san- 
itary drink. 

DUTIES    OF    PERSONS    EMPLOYED. 

In  cases  where  the  cooperation  of  the  workers  is  required  for  carrying  out 
the  foregoing  rules  and  where  such  cooperation  is  not  given,  the  workers  shall 
be  held  liable,  in  accordance  with  the  factory  and  workshop  act,  1891,  section  9, 
which  runs  as  follows : 

"  If  any  person  who  is  bound  to  observe  any  special  rules  established  for  any 
factory  or  workshop  under  this  act,  acts  in  contravention  of,  or  fails  to  comply 
with,  any  such  special  rule,  he  shall  be  liable  on  summary  conviction  to  a  fine 
not  exceeding  £2  ($9.73)." 

Respirators.— A  good  respirator  is  a  cambric  bag  with  or  without  a  thin 
flexible  wire  made  to  fit  over  the  nose. 

Safiitary  drink  suggested. — Sulphate  of  magnesia,  2  ounces ;  water,  1  gallon ; 
essence  of  lemon,  sufficient  to  flavor. 


336  BEPOETS  OF   THE  PRESIDENT'S  HOMES   COMMISSION. 

Lead  Smelting  Works. 

[Form  264— January,  1906.] 

DUTIES    OF    OCCUPIEBS. 

They  shall  provide  respirators  and  overall  suits  for  the  use  of  all  persons 
employed  in  cleaning  the  flues,  and  take  means  to  see  that  the  same  are  used. 

They  shall  arrange  that  no  person  be  allowed  to  remain  at  work  more  than 
two  hours  at  a  time  in  a  flue.  (A  rest  of  half  an  hour  before  reentering  will 
be  deemed  sufficient.) 

They  shall  provide  sufficient  bath  accommodation  for  all  persons  employed  in 
cleaning  the  flues,  and  every  one  so  employed  shall  take  a  bath  before  leaving 
the  works. 

They  shall  provide  washing  conveniences,  with  a  sufficient  supply  of  hot 
and  cold  water,  soap,  nailbrushes,  and  towels. 

DUTIES   OF  PERSONS   EMPLOYED. 

In  cases  where  the  cooperation  of  the  workers  is  required  for  carrying  out 
the  foregoing  rules,  and  where  such  cooperation  is  not  given,  the  workers  shall 
be  held  liable,  in  accordance  with  the  factory  and  workshop  act,  1891,  section 
9,  which  runs  as  follows : 

"  If  any  person  who  is  bound  to  observe  any  special  rules  established  for  any 
factory  or  workshop  under  this  act,  acts  in  contravention  of,  or  fails  to  comply 
with,  4ny  such  special  rule,  he  shall  be  liable  on  summary  conviction  to  a 
fine  not  exceeding  £2  ($9.73)." 

Special  Rules  for  Factories  oe  Workshops  in  which  Yellow  Chromate 
OF  Lead  is  Used,  ob  in  which  Goods  Dyed  with  It  Undergo  the  Proc- 
esses OF  Building  ob  Noddling,  Winding,  Reeling,  W^eaving,  ob  any  otheb 
Tbeatment. 

[Form  270 — February,  1904.] 
DUTIES   OF   occupiers. 

They  shall  provide  washing  conveniences,  with  a  sufficient  supply  of  hot  and 
cold  water,  soap,  nailbrushes,  and  towels. 

They  shall  provide  respirators  and  overall  suits  for  the  persons  employed  in 
all  dry  processes. 

They  shall  provide  fans  and  other  suitable  means  of  ventilation  wherever 
dust  is  generated  in  the  process  of  manufacture. 

They  shall  provide  a  sufficient  supply  of  epsom  salts,  and  of  the  sanitary 
drink  mentioned  below,  or  some  other  approved  by  His  Majesty's  inspector  of 
factories. 

Respirators. — ^A  good  respirator  is  a  cambric  bag  with  or  without  a  thin 
flexible  wire  made  to  fit  over  the  nose. 

Sanitary  drink. — Sulphate  of  magnesia,  2  ounces ;  water,  1  gallon ;  essence  of 
lemon,  sufficient  to  flavor. 

DUTIES   OF  PERSONS   EMPLOYED. 

Every  person  to  whom  is  supplied  a  respirator  or  overall  suit  shall  wear  the 
same  when  at  the  special  work  for  which  such  are  provided. 

Every  person  shall  carefully  clean  and  wash  hands  and  face  before  meals 
and  before  leaving  the  works. 

No  food  shall  be  eaten  in  any  part  of  the  works  in  which  yellow  chromate 
of  lead  is  used  in  the  manufacture. 

Abthub  Whitelegge, 
E.  M.  Chief  Inspector  of  Factories. 

Under  section  9,  Factory  Act,  1891,  any  person  who  Is  bound  to  observe  any 
special  rules  is  liable  to  penalties  for  noncompliance  with  such  special  rules. 


REPORTS    OF   THE  PRESIDENT'S   HOMES   COMMISSION.  337 

Amended  Special  Rules  foe  the  Manufacture  and  Decoration  of  Earthen- 
ware AND  China. 

[As  established,  after  arbitration,  by  the  awards  of  the  umpire.  Lord  James  of  Hereford, 
dated  30th  of  December,  1901,  and  28th  of  November,  1903.] 

[Form  923— October,  1905.] 
DUTIES   OF   occupiers. 

1.  Deleted. 

2.  After  tbe  1st  day  of  February,  1904,  no  glaze  shall  be  used  which  yields  to 
a  dilute  solution  of  hydrochloric  acid  more  than  5  per  cent  of  its  dry  weight 
of  a  soluble  lead  compound  calculated  as  lead  monoxide  when  determined  in 
the  manner  described  below. 

A  weighed'  quantity  of  dried  material  is  to  be  continuously  shaken  for  one 
hour,  at  the  common  temperature,  with  one  thousand  times  its  weight  of  an 
aqueous  solution  of  hydrochloric  acid  containing  0.25  per  cent  of  HCl.  This 
solution  is  thereafter  to  be  allowed  to  stand  for  one  hour,  and  to  be  passed 
through  a  filter.  The  lead  salt  contained  In  an  aliquot  portion  of  the  clear 
filtrate  is  then  to  be  precipita.ted  as  lead  sulphide  and  weighed  as  lead  sulphate. 

If  any  occupier  shall  give  notice  in  writing  to  tlie  inspector  for  the  district 
that  he  desires  to  use  glaze  which  does  not  conform  to  the  above-mentioned  con- 
ditions, and  to  adopt  in  his  factory  the  scheme  of  compensation  prescribed  in 
Schedule  B,  and  shall  affix  and  keep  the  same  affixed  in  his  factory,  the  above 
provisions  shall  not  apply  to  his  factory,  but  instead  thereof  the  following 
provisions  shall  apply : 

All  persons  employed  in  any  process  Included  in  Schedule  A  other  than  china 
scouring  shall  be  examined  before  the  commencement  of  their  employment, 
or  at  the  first  subsequent  visit  of  the  certifying  surgeon,  and  once  in  each 
calendar  month  by  the  certifying  surgeon  of  the  district. 

The  certifying  surgeon  may  at  any  time  order  by  signed  certificate  the  sus- 
pension of  any  such  person  from  employment  in  any  process  included  in 
Schedule  A  other  than  china  scouring,  if  such  certifying  surgeon  is  of  opinion 
that  such  person  by  continuous  work  in  lead  will  incur  special  danger  from  the 
effects  of  plumbism,  and  no  person  after  such  suspension  shall  be  allowed 
to  work  in  any  process  included  in  Schedule  A  other  than  china  scouring 
without  a  certificate  of  fitness  from  the  certifying  surgeon  entered  in  the 
register. 

Any  workman  who,  by  reason  of  his  employment  being  intermittent  or 
casual,  or  of  his  being  in  regular  employment  for  more  than  one  employer,  is 
unable  to  present  himself  regularly  for  examination  by  the  certifying  surgeon, 
may  procure  himself  at  his  own  expense  to  be  examined  once  a  month  by  a 
certifying  surgeon,  and  such  examination  shall  be  a  sufficient  compliance  with 
this  rule.  The  results  of  such  examination  shall  be  entered  by  the  certifying 
surgeon  in  a  book  to  be  kept  in  the  possession  of  the  workman.  He  shall 
produce  and  show  the  said  book  to  a  factory  inspector  or  to  any  employer  on 
demand,  and  he  shall  not  make  any  entry  or  erasure  therein. 

If  the  occupier  of  any  factory  to  which  this  rule  applies  fails  to  duly  observe 
the  conditions  of  the  said  scheme,  or  if  any  such  factory  shall  by  reason  of  the 
occurrence  of  cases  of  lead  poisoning  appear  to  the  secretary  of  state  to  be  in 
an  unsatisfactory  condition,  he  may,  after  nn  inquirj^,  at  which  the  occupier 
shall  have  an  opportunity  of  being  heard,  prohibit  the  use  of  lead  for  such  time 
and  subject  to  such  conditions  as  he  may  prescribe. 

All  persons  employed  in  the  processes  included  in  Schedule  A,  other  than 
china  scouring,  shall  present  themselves  at  the  appointed  time  for  examination 
by  the  certifying  surgeon,  as  provided  in  this  rule. 

In  addition  to  the  examinations  at  the  appointed  times,  any  person  so  em- 
ployed may  at  any  time  present  himself  to  the  certifying  surgeon  for  examina- 
tion, and  shall  be  examined  on  paying  the  prescribed  fee. 

All  persons  shall  obey  any  directions  given  by  the  certifying  surgeon. 

No  person  after  suspension  by  the  certifying  surgeon  shall  work  in  any  proc- 
ess included  in  Schedule  A,  other  than  china  scouring,  without  a  certificate 
of  fitness  from  the  certifying  surgeon  entered  in  the  register.  Any  operative 
who  fails  without  reasonable  cause  to  attend  any  monthly  examination  shall 
procure  himself,  at  his  own  expense,  to  be  examined  within  fourteen  days  there- 
after by  the  certifying  surgeon,  and  shall  himself  pay  the  prescribed  fee. 

S.  Doc.  644,  60-2 23 


338  REPORTS   OF   THE  PRESIDENT  S   HOMES   COMMISSION. 

A  register,  in  the  form  whicli  has  been  prescribed  by  the  secretary  of  state 
for  use  in  earthenware  and  chhia  works,  shall  be  kept,  and  in  it  the  certifying 
surgeon  shall  enter  the  dates  and  results  of  his  visits,  the  number  of  persons 
examined,  and  particulars  of  any  directions  given  by  him.  This  register  shall 
contain  a  list  of  all  persons  employed  in  the  processes  included  in  Schedule  A, 
or  in  emptying  china  biscuit  ware,  and  shall  be  produced  at  any  time  when 
required  by  His  Majesty's  inspectors  of  factories  or  by  the  certifying  surgeon. 

3.  The  occupier  shall  allow  any  of  His  Majesty's  inspectors  of  factories  to 
take  at  any  time  sufficient  samples  for  analysis  of  any  material  in  use  or  mixed 
for  use. 

Provided  that  the  occupier  may  at  the  time  when  the  sample  is  taken,  and 
on  providing  the  necessary  appliances,  require  the  inspector  to  take,  seal,  and 
deliver  to  him  a  duplicate  sample. 

But  no  analytical  result  shall  be  disclosed  or  published  in  any  way  except 
such  as  shall  be  necessary  to  establish  a  breach  of  these  rules. 

4.  No  woman,  young  person,  or  child  shall  be  employed  in  the  mixing  of 
unfritted  lead  compounds  in  the  preparation  or  manufacture  of  fritts,  glazes, 
or  colors. 

5.  No  person  under  15  years  of  age  shall  be  employed  in  any  process  included 
in  Schedule  A,  or  in  emptying  china  biscuit  ware. 

Thimble  picking,  or  threading  up,  or  looking  over  biscuit  ware  shall  not  be 
carried  on  except  in  a  place  sufficiently  separated  from  any  process  included  in 
Schedule  A. 

6.  All  women  and  young  persons  employed  in  any  process  included  in  Schedule 
A  shall  be  examined  once  in  each  calendar  month  by  the  certifying  surgeon  for 
the  district. 

The  certifying  surgeon  may  order  by  signed  certificate  in  the  register  the 
suspension  of  any  such  women  or  young  persons  from  employment  in  any 
process  included  in  Schedule  A,  and  no  person  after  such  suspension  shall  be 
allowed  to  work  in  any  process  included  in  Schedule  A  without  a  certificate  of 
fitness  from  the  certifying  surgeon  entered  in  the  register. 

7.  A  register,  in  the  form  which  has  been  prescribed  by  the  secretary  of 
state  for  use  in  earthenware  and  china  works,  shall  be  kept,  and  in  it  the  cer- 
tifying surgeon  shall  enter  the  dates  and  results  of  his  visits,  the  number  of 
persons  examined  in  pursuance  of  rule  6  as  amended,  and  particulars  of  any 
directions  given  by  him.  This  register  shall  contain  a  list  of  all  persons  em- 
ployed in  the  processes  included  in  Schedule  A,  or  in  emptying  china  biscuit 
ware,  and  shall  be  produced  at  any  time  when  required  by  His  Majesty's  in- 
spector of  factories  or  by  the  certifying  surgeon. 

8.  The  occupier  shall  provide  and  maintain  suitable  overalls  and  head  cov- 
erings for  all  women  and  young  persons  employed  in  the  processes  included  in 
the  Schedule  A,  or  in  emptying  china  biscuit  ware. 

No  person  shall  be  allowed  to  work  in  any  process  included  in  the  schedule, 
or  in  emptying  china  biscuit  ware,  without  wearing  suitable  overalls  and  head 
coverings,  provided  that  nothing  in  this  rule  shall  render  it  obligatory  on  any 
person  engaged  in  drawing  glost  ovens  to  wear  overalls  and  head  coverings. 

All  overalls,  head  coverings,  and  respirators,  when  not  in  use  or  being  washed 
or  repaired,  shall  be  kept  by  the  occupier  in  proper  custody.  They  shall  be 
washed  or  renewed  at  least  once  a  week,  and  suitable  arrangements  shall  be 
made  by  the  occupier  for  carrying  out  these  requirements. 

A  suitable  place,  other  than  that  provided  for  the  keeping  of  overalls,  head 
coverings,  and  respirators,  in  which  all  the  above  workers  can  deposit  clothing 
put  off  during  working  hours,  shall  be  provided  by  the  occupier. 

Each  respirator  shall  bear  the  distinguishing  mark  of  the  worker  to  whom  it 
is  supplied. 

9.  No  person  shall  be  allowed  to  keep,  or  prepare,  or  partake  of  any  food,  or 
drink,  or  tobacco,  or  remain  during  meal  times  in  a  place  in  which  is  carried  on 
any  process  included  in  Schedule  A. 

The  occupier  shall  make  suitable  provision  to  the  reasonable  satisfaction  of 
the  inspector  in  charge  of  the  district  for  the  accommodation  during  meal 
times  of  persons  employed  in  such  places  or  processes,  with  a  right  of  appeal 
to  the  chief  inspector  of  factories.  Such  accommodation  shall  not  be  provided 
in  any  room  or  rooms  in  which  any  process  included  in  Schedule  A  is  carried  on, 
and  no  washing  conveniences  mentioned  hereafter  in  rule  13  shall  be  main- 
tained in  any  room  or  rooms  provided  for  such  accommodations. 

SuitTible  provision  shall  be  made  for  the  deposit  of  food  brought  by  the 
workers. 


REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  339 

10.  The  processes  of  the  towing  of  earthenware,  china  scouring,  ground  lay- 
ing, ware  cleaning  after  the  dipper,  color  dusting,  whether  on  glaze  or  under- 
glaze,  color  blowing,  whether  on  glaze  or  under-glaze,  glaze  blowing,  or  transfer 
nialiing,  shall  not  be  carried  on  without  the  use  of  exhaust  fans,  or  other 
efficient  means  for  the  effectual  removal  of  dust,  to  be  approved  in  each  partic- 
ular case  by  the  secretary  of  state,  and  other  such  conditions  as  he  may  from 
time  to  time  prescribe. 

In  the  process  of  ware  cleaning  after  the  dipper,  sufficient  arrangements  shall 
be  made  for  any  glaze  scraped  off  which  is  not  removed  by  the  fan,  or  the 
other  efficient  means,  to  fall  into  water. 

In  the  process  of  ware  cleaning  of  earthenware  after  the  dipper,  damp  sponges 
or  other  damp  material  shall  be  provided  in  addition  to  the  knife  or  other 
instrument,  and  shall  be  used  wherever  practicable. 

Flat-knocking  and  fired-flint  sifting  shall  be  carried  on  only  in  inclosed  re- 
ceptacles, which  shall  be  connected  with  an  efficient  fan  or  other  efficient  draft, 
unless  so  contrived  as  to  prevent  effectually  the  escape  of  injurious  dust. 

In  all  processes  the  occupier  shall,  as  far  as  practicable,  adopt  efficient 
measures  for  the  removal  of  dust  and  for  the  prevention  of  any  injurious  ef- 
fects arising  therefrom. 

11.  No  person  shall  be  employed  in  the  mixing  of  unfritted  lead  compounds, 
in  the  preparation  or  manufacture  of  fritts,  glazes,  or  colors  containing  lead 
without  wearing  a  suitable  and  efficient  respirator  provided  and*  maintained  by 
the  employer,  unless  the  mixing  is  performed  in  a  closed  machine  or  the  ma- 
terials are  in  such  a  condition  that  no  dust  is  produced. 

Each  respirator  shall  bear  the  distinguishing  mark  of  the  worker  to  whom  it 
is  supplied. 

12.  All  drying  stoves  as  well  as  all  workshops  and  all  parts  of  factories  shall 
be  effectually  ventilated  to  the  reasonable  satisfaction  of  the  inspector  in  charge 
of  the  district. 

13.  The  occupier  shall  provide  and  continually  maintain  sufficient  and  suit- 
able washing  conveniences  for  all  persons  employed  in  the  processes  included  in 
Schedule  A,  as  near  as  practicable  to  the  places  in  which  such  persons  are  em- 
ployed. 

The  washing  conveniences  shall  comprise  soap,  nailbrushes,  and  towels,  and 
at  least  one  wash  hand  basin  for  every  five  persons  employed  as  above,  with  a 
constant  supply  of  water  laid  on,  with  one  tap  at  least  for  every  two  basins, 
and  conveniences  for  emptying  the  same  and  running  off  the  waste  water  on 
the  spot  down  a  waste  pipe. 

There  shall  be  in  front  of  each  washing  basin,  or  convenience,  a  space  for 
standing  room  which  shall  not  be  less  in  any  direction  than  21  inches. 

14.  The  occupier  shall  see  that  the  floors  of  workshops  and  of  such  stoves  as 
are  entered  by  the  work  people  are  sprinkled  and  swept  daily;  that  all  rust, 
scraps,  ashes,  and  dirt  are  removed  daily,  and  that  the  mangles,  workbenches, 
and  stairs  leading  to  workshops  are  cleaned  weekly. 

When  so  required  by  the  inspector  in  charge  of  the  district,  by  notice  in 
writing,  any  such  floors,  mangles,  workbenches,  and  stairs  shall  be  cleansed  in 
such  manner  and  at  such  times  as  may  directed  in  such  notice. 

As  regards  every  potter's  shop  and  stove,  and  every  place  in  which  any  proc- 
ess included  in  Schedule  A  is  carried  on,  the  occupier  shall  cause  the  sufficient 
cleansing  of  floors  to  be  done  at  a  time  when  no  other  work  is  being  carried  on 
in  such  room,  and  in  the  case  of  potters'  shops,  stoves,  dipping  houses,  and 
majolica  painting  rooms,  by  an  adult  male. 

Provided  that  in  the  case  of  rooms  in  which  ground  laying  or  glost  placing  is 
carried  on,  or  in  china  dippers'  drying  room,  the  cleansing  prescribed  by  this 
rule  may  be  done  before  work  commences  for  the  day,  but  in  no  case  shall  any 
work  be  carried  on  in  the  room  within  one  hour  after  any  such  cleansing  as 
aforesaid  has  ceased. 

15.  The  occupier  shall  cause  the  boards  used  in  the  dipping  house,  dippers' 
drying  room,  or  glost  placing  shop  to  be  cleansed  every  week,  and  shall  not 
allow  them  to  be  used  in  any  other  department,  except  after  being  cleansed. 

When  so  required  by  the  inspector  in  charge  of  the  district,  by  notice  in 
writing,  any  such  boards  shall  be  washed  at  such  times  as  may  be  direcLcJ  in 
such  notice. 


340  KEPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

DUTIES   OF   PERSONS   EMPLOYED. 

Itj.  All  women  and  young  persons  employed  in  the  processes  included  In 
Schedule  A  shall  present  themselves  at  the  appointed  time  for  examination  by 
the  certifying  surgeon  as  provided  in  rule  6  as  amended. 

No  person  after  suspension  by  the  certifying  surgeon  shall  work  in  any  proc- 
ess included  in  the  schedule  without  a  certificate  of  fitness  from  the  certifymg 
surgeon  entered  in  the  register. 

17.  Every  person  employed  in  any  process  included  in  Schedule  A,  or  in 
emptying  china  biscuit  ware,  shall,  when  at  work,  wear  a  suitable  overall  and 
head  covering,  and  also  a  respirator  when  so  required  by  rule  11  as  amended, 
which  shall  not  be  worn  outside  the  factory  or  workshop  and  which  shall  not  be 
removed  therefrom,  except  for  the  purpose  of  being  washed  or  repaired.  Such 
overall  and  head  covering  shall  be  in  proper  repair  and  duly  washed. 

The  hair  must  be  so  arranged  as  to  be  fully  protected  from  dust  by  the  head 
covering. 

The  overalls,  head  coverings,  and  respirators,  when  not  being  worn,  and 
clothing  put  off  during  working  hours,  shall  be  deposited  in  the  respective 
places  provided  by  the  occupier  for  such  purposes  under  rule  8  as  amended. 

18.  No  person  shall  remain  during  meal  times  in  any  place  in  which  is  carried 
on  any  process  included  in  Schedule  A,  or  introduce,  keep,  prepare,  or  partake 
of  any  food  or  'drink  or  tobacco  therein  at  any  time. 

19.  No  person  shall  in  any  way  interfere,  without  the  knowledge  and  concur- 
rence of  the  occupier  or  manager,  with  the  means  and  appliances  provided  by 
the  employers  for  the  ventilation  of  the  workshops  and  stoves,  and  for  the 
removal  of  dust. 

20.  No  person  included  in  any  process  included  in  Schedule  A  shall  leave  the 
works  or  partake  of  meals  without  previously  and  carefully  cleaning  and  wash- 
ing his  or  her  hands. 

No  person  employed  shall  remove  or  damage  the  washing  basins  or  conveni- 
ences provided  under  rule  13. 

20a.  The  persons  appointed  by  the  occupiers  shall  cleanse  the  several  parts  of 
the  factory  regularly,  as  prescribed  in  rule  14. 

Every  worker  shall  so  conduct  his  or  her  work  as  to  avoid,  as  far  as  practi- 
cable, making  or  scattering  dust,  dirt,  or  refuse,  or  causing  accumulation  of 
such. 

21.  The  boards  used  In  the  dipping  house,  dippers'  drying  room,  or  glost 
placing  shop  shall  not  be  used  in  any  other  department,  except  after  being 
cleansed,  as  directed  in  rule  15. 

EXEMPTION    F#E    PBOCESSES    IN    WHICH    NO    LEAD    OB    OTHEB    POISONOUS    MATERIAL 

IS   USED. 

22.  If  the  occupier  of  a  factory  to  which  these  rules  apply  gives  with  reference 
to  any  process  included  in  Schedule  A,  other  than  china  scouring,  an  undertak- 
ing that  no  lead  or  lead  compound  or  other  poisonous  material  shall  be  used, 
the  chief  inspector  may  approve  in  writing  of  the  suspension  of  the  operation  of 
rules  4,  5,  6,  7,  8,  15,  16,  17,  and  21,  or  any  of  them  in  such  process ;  and  there- 
upon such  rules  shall  be  suspended  as  regards  the  process  named  in  the  chief 
Inspector's  approval,  and  in  lieu  thereof  the  following  rule  shall  take  effect,  viz, 
No  lead  or  lead  compound  or  other  poisonous  material  shall  be  used  in  any 
process  so  named. 

For  the  purpose  of  this  rule  materials  that  contain  no  more  than  1  per  cent  of 
lead  shall  be  regarded  as  free  from  lead. 

Note. — ^These  rules  must  be  kept  posted  up  in  conspicuous  places  in  the  factory 
to  which  they  apply,  where  they  may  be  conveniently  read  by  persons  employed. 
Any  i)erson  who  is  bound  to  observe  these  rules  and  fails  to  do  so,  or  acts  in 
contravention  to  them,  is  liable  to  a  penalty,  and  in  such  cases  the  occupier 
also  is  liable  to  a  penalty  unless  he  proves  that  he  has  taken  all  reasonable 
means,  by  publishing  and  to  the  best  of  his  power  enforcing  the  rules,  to  prevent 
the  contravention  or  non-compliance. 

Schedule  A. 

Dipping  or  other  process  carried  on  in  the  dipping  house. 

Glaze  blowing. 

Painting  in  majolica  or  other  glaze. 


EEPOKTS   OF   THE  PKESIDENT^S  HOMES  COMMISSION.  341 

Drying  after  clipping. 

Ware  cleaning  after  the  application  of  glaze  by  dipping  or  other  process. 

China  scouring. 

Glost  placing. 

Ground  laying. 

S!or  blowtag  }  ^'•«*«^  «"-^'^^«  "^  nnder-glaze. 

Lithographic  transfer  malting. 

Maliing  or  mixing  of  fruits,  glazes,  or  colors  containing  lead. 

Any  other  process  in  which  materials  containiiic;  lead  are  used  or  handled  In 
the  dry  state,  or  in  the  form  of  spray,  or  in  suspension  in  liquid  other  than  oil 
or  similar  medium. 

Schedule  A. — Notice  to  workmen  employed  in  process  named  in  Schedule  A, 
other  than  china  scouring, 

CONDITIONS   or   COMPENSATION. 

1.  Where  a  workman  is  suspended  from  working  by  a  certifying  surgeon  of 
the  district  on  the  ground  that  he  is  of  opinion  that  such  person  by  continued 
work  ill  lead  will  incur  special  danger  from  the  effects  of  plumbism,  and  the 
certifying  surgeon  shall  certify  that  in  his  opinion  he  is  suffering  from  plumbism 
arising  out  of  his  employment,  he  shall,  subject  as  hereinafter  mentioned,  be 
entitled  to  compensation  from  his  employer  as  hereinafter  provided. 

(a)  If  any  workman  who  has  been  suspended  as  aforesaid  dies  within  nine 
calendar  months  from  the  date  of  such  certificate  of  suspension,  by  reason  of 
plumbism  contracted  before  said  date,  there  shall  be  paid  to  such  of  his  de- 
pendents as  are  wholly  dependent  upon  his  earnings  at  the  time  of  his  death 
or  upon  the  weekly  compensation  payable  under  this  scheme,  a  sum  equal  to  the 
amount  he  has  earned  during  a  period  of  three  years  next  preceding  the  date  of 
the  said  certificate,  such  sum  not  to  be  more  than  £300  ($1,459.95)  nor  less  than 
£150  ($729.98)  for  an  adult  male,  £100  ($486.65)  for  an  adult  female,  and  £75 
($364.99)  for  a  young  person. 

(&)  If  the  workman  does  not  leave  any  dependents  wholly  dependent  as 
aforesaid,  but  leaves  any  dependents  in  part  dependent  as  aforesaid,  a  reason- 
able part  of  that  sum. 

(c)  If  he  leaves  no  dependents,  the  reasonable  expenses  of  his  medical  at- 
tendance and  burial,  not  exceeding  £10. 

2.  With  respect  to  such  payments  the  following  provisions  shall  apply — 

(a)  All  sums  paid  to  the  workmen  as  compensation  since  the  date  of  the  said 
certificate  shall  be  deducted  from  the  sums  payable  to  the  dependents. 

( & )  The  payment  shall,  in  case  of  death,  be  made  to  the  legal  personal  repre- 
sentative of  the  workingman,  or,  if  he  has  no  legal  personal  representative,  to 
or  for  the  benefit  of  his  dependents,  or,  if  he  leaves  no  dependents,  to  the  person 
to  wliom  the  expenses  are  due;  and  if  made  to  the  legal  personal  representative, 
shall  be  paid  by  him  to  or  for  the  benefit  of  the  dependents  or  other  person 
entitled  thereto. 

(c)  Any  question  as  to  who  is  a  dependent,  or  as  to  the  amount  payable  to 
each  dependent,  shall,  in  default  of  agreement,  be  settled  by  arbitration  as  here- 
inafter provided  in  clause  9. 

{d)  The  sum  allotted  as  compensation  to  a  dependent  may  be  invested  or 
otherwise  applied  for  the  benefit  of  the  person  entitled  thereto,  as  agreed,  or  as 
ordered  by  the  arbitrator. 

(e)  Any  sum  which  is  agreed  or  is  ordered  by  the  arbitrator  to  be  invested 
may  be  invested  in  whole  or  in  part  in  the  post-office  savings  bank. 

3.  Where  a  workman  has  been  suspended  and  certified  as  provided  in  condi- 
tion 1,  and  while  he  is  totally  or  partially  prevented  from  earning  a  living  by 
reason  of  such  suspension,  he  shall  be  entitled  to  a  weekly  payment  not  exceed- 
ing 50  per  cent  of  his  average  weekly  earnings  at  the  time  of  such  suspension, 
such  payment  not  to  exceed  £1  ($4.87).  The  average  may  be- taken  gver  such 
period,  not  exceeding  twelve  months,  as  appears  fair  or  reasonable,  having 
regard  to  all  the  circumstances  of  the  case. 

4.  In  fixing  these  weekly  payments  regard  shall  be  had  to  the  difference 
between  the  amount  of  the  average  weekly  earnings  of  the  workman  at  the  time 
of  his  suspension  and  the  average  amount,  if  any,  which  it  is  estimated  that  he 
will  be  able  to  earn  afterwards  in  any  occupation  or  employment,  and  to  any 
paymaits  (not  being  wages)  which  he  may  have  received  from  the  employer  in 


342  BEPOKTS   OF   THE   PKESTDENt's   HOMES   COMMISSION. 

respect  of  the  suspension,  and  to  all  the  circumstances  of  the  case,  including  his 
age  and  expectation  of  life. 

5.  If  it  shall  appear  that  any  workman  has  persistently  disobeyed  the  special 
rules  or  the  directions  given  for  his  protection  by  his  employers,  and  that  such 
disobedience  has  conduced  to  his  suspension,  or  has  not  presented  himself  for 
examination  by  the  certifying  surgeon,  or  has  failed  to  give  full  information 
and  assistance  as  provided  in  condition  6,  his  conduct  may  be  taken  into  con- 
sideration in  assessing  the  amount  of  the  weekly  payments. 

6.  It  shall  be  the  duty  of  every  workman  at  all  times  to  submit  to  medical 
examination  when  required  and  to  give  full  information  to  the  certifying  sur- 
geon and  to  assist  to  the  best  of  his  power  in  the  obtaining  of  all  facts  necessary 
to  enable  his  physical  condition  to  be  ascertained. 

7.  Any  weekly  payment  may  be  reviewed  at  the  request  either  of  the  employer 
or  of  the  workman,  and  on  such  review  may  be  ended,  diminished,  or  increased, 
subject  to  the  maximum  above  provided,  and  the  amount  of  payment  shall,  in 
default  of  agreement,  be  settled  by  arbitration. 

8.  Any  workman  receiving  weekly  payments  under  this  scheme  shall  submit 
himself,  if  required,  for  examination  by  a  duly  qualified  medical  practitioner 
provided  and  paid  by  the  employer. 

If  the  workman  refuses  to  submit  himself  to  such  examination  or  in  any  way 
obstructs  the  same,  his  right  to  such  weekly  payments  shall  be  suspended  until 
such  examination  has  taken  place. 

9.  If  any  dispute  shall  arise  as  to  any  certificate  of  the  certifying  surgeon  or 
as  to  the  amount  of  compensation  payable  as  herein  provided,  or  otherwise  in 
relation  to  these  provisions,  the  same  shall  be  decided  by  an  arbitrator  to  be 
appointed  by  the  employer  and  workman,  or  in  default  of  agreement  by  the 
secretary  of  state.  The  said  arbitrator  shall  have  nU  the  powers  of  an  arbitra- 
tor under  the  arbitration  act,  and  his  decision  shall  be  final. 

The  fee  of  the  arbitrator  shall  be  fixed  by  the  secretary  of  state,  and  shall  be 
paid  as  the  arbitrator  shall  direct. 

10.  No  compensation  shall  be  payable  under  these  provisions  unless  notice 
of  claim  in  writing  is  made  within  six  weeks  of  the  date  of  the  certificate  of 
suspension,  or  of  the  death,  provided  that  the  want  of  such  notice  shall  not  bar 
the  claim  if  in  the  opinion  of  the  arbitrator  there  was  reasonable  excuse  for  the 
want  of  it. 

A  claim  for  compensation  by  any  workman  whose  employment  is  intermittent, 
or  casual,  or  who  is  regularly  employed  by  more  than  one  employer,  shall  only 
arise  against  the  employers  for  whom  he  has  worked  in  a  process  included  in 
Schedule  A  within  one  month  prior  to  his  suspension.  The  said  employers  shall 
bear  the  compensation  among  them  in  such  proportion  as  in  default  of  agreement 
shall  be  determined  by  an  arbitrator  as  herein  provided. 

11.  "  Employer "  includes  an  occupier,  a  corporation,  and  the  legal  repre- 
sentatives of  a  deceased  employer.  "Workman  "  includes  every  person,  male  or 
female,  whether  his  agreement  be  one  of  service  or  apprenticeship  or  otherwise, 
and  is  expressed  or  implied,  orally,  or  in  writing,  and  shall  include  the  personal 
representatives  of  a  deceased  workman.  "  Dependents  "  has  the  same  meaning 
as  in  the  workmen's  compensation  act,  1897. 

The  terms  contained  in  this  notice  shall  be  deemed  to  be  part  of  the  contract 
of  employment  of  all  workmen  in  the  above-named  process. 

Electric  Accumtjlatobs. 

Whereas  the  manufacture  of  electric  accumulators  has  been  certified  in  pur- 
suance of  section  79  of  the  factory  and  wojdishop  act,  1901,  to  be  dangerous ; 

I  hereby,  in  pursuance  of  the  powers  conferred  on  me  by  that  act,  make  the 
following  regulations,  and  direct  that  they  shall  apply  to  all  factories  and  work- 
shops or  parts  thereof  in  which  electric  accumulators  are  manufactured. 

In  these  regulations  "  lead  process  "  means  pasting,  casting,  lead  burning,  or 
any  work  involving  contact  with  dry  compounds  of  lead. 

Any  approval  given  by  the  chief  inspector  of  factories  in  pursuance  of  these 
regulations  shall  be  given  in  writing,  and  may  at  any  time  be  revoked  by  notice 
in  writing  signed  by  him. 


KEPORTS    OF    THE   PRESIDENT'S   HOMES   COMMISSION.  343 

DUTIES  OF  OCCUPIER. 

1.  Every  room  in  wbich  casting,  pasting,  or  lead  burning  is  carried  on  sliall 
contain  at  least  500  cubic  feet  of  air  space  for  each  person  employed  therein, 
and  in  computing  this  air  space,  no  height  above  14  feet  shall  be  taken  into 
account. 

These  rooms  and  that  in  which  the  plates  are  formed  shall  be  capable  of 
thorough  ventilation.     They  shall  be  provided  with  windows  made  to  open. 

2.  Each  of  the  following  processes  shall  be  carried  on  in  such  manner  and 
under  such  conditions  as  to  secure  effectual  separation  from  one  another  and 
from  any  other  process : 

(a)  Manipulation  of  dry  compounds  of  lead. 

(6)  Pasting. 

(c)  Formation,  and  lead  burning  necessarily  carried  on  therewith. 

(d)  Melting  down  of  old  plates. 

Provided  that  manipulation  of  dry  compounds  of  lead  carried  on  as  in  regula- 
tion 5  (&)  need  not  be  separated  from  pasting. 

3.  The  floors  of  the  rooms  in  which  manipulation  of  dry  compounds  of  lead  or 
pasting  is  carried  on  shall  be  of  cement  or  similar  impervious  material,  and 
shall  be  kept  constantly  moist  while  work  is  being  done. 

The  floors  of  these  rooms  shall  be  washed  with  a  hose  pipe  daily. 

4.  Every  melting  pot  shall  be  covered  with  a  hood  and  shaft  so  arranged 
as  to  remove  the  fumes  and  hot  air  from  the  workrooms. 

Lead  ashes  and  old  plates  shall  be  kept  in  receptacles  specially  provided  for 
the  purpose. 

5.  Manipulation  of  dry  compounds  of  lead  in  the  mixing  of  the  paste  or  other 
processes  shall  not  be  done  except  (a)  in  any  apparatus  so  closed,  or  so  arranged 
with  an  exhaust  draft,  as  to  prevent  the  escape  of  dust  into  the  workroom  ;  or, 
(&)  at  a  bench  provided  with  (1)  efiicient  exhaust  draft  and  air  guide  so 
arranged  as  to  draw  the  dust  away  from  the  worker,  and  (2)  a  grating  on  which 
each  receptacle  of  the  compound  of  lead  in  use  at  the  time  shall  stand. 

6.  The  benches  at  which  pasting  is  done  shall  be  covered  with  sheet  lead  or 
other  impervious  material,  and  shall  have  raised  edges. 

7.  No  woman,  young  person,  or  child  shall  be  employed  in  the  manipulation  of 
dry  compounds  of  lead  or  in  pasting. 

8.  (a)  A  duly  qualified  medical  practitioner  (in  these  regulations  referred  to 
as  the  "  appointed  surgeon  " ) ,  who  may  be  the  certifying  surgeon,  shall  be  ap- 
pointed by  the  occupier,  such  appointment  unless  held  by  the  certifying  surgeon 
to  be  subject  to  the  approval  of  the  chief  inspector  of  factories.- 

(&)  Every  person  employed  in  a  lead  process  shall  be  examined  once  a  month 
by  the  appointed  surgeon,  who  shall  have  power  to  suspend  from  employment  in 
any  lead  process. 

(c)  No  person  after  such  suspension  shall  be  employed  in  a  lead  process 
without  written  sanction  entered  in  the  health  register  by  the  appointed  sur- 
geon. It  shall  be  sufficient  compliance  with  this  regulation  for  a  written  cer- 
tificate to  be  given  by  the  appointed  surgeon  and  attached  to  the  health  register, 
such  certificate  to  be  replaced  by  a  proper  entry  in  the  health  register  at  the 
appointed  surgeon's  next  visit. 

(d)  A  health  register  in  a  form  approved  by  the  chief  inspector  of  factories 
shall  be  kept,  and  shall  contain  a  list  of  all  persons  employed  in  lead  processes. 
The  appointed  surgeon  will  enter  in  the  health  register  the  dates  and  results 
of  his  examinations  of  the  persons  employed  and  particulars  of  any  directions 
given  by  him.  He  shall  on  a  prescribed  form  furnish  to  the  chief  inspector  of 
factories  on  the  1st  day  of  January  in  each  year  a  list  of  the  persons  suspended 
by  him  during  the  previous  year,  the  cause  and  duration  of  such  suspension, 
and  the  number  of  examinations  made. 

The  health  register  shall  be  produced  at  any  time  when  required  by  His 
Majesty's  inspectors  of  factories  or  by  the  certifying  surgeon  or  by  the  ap- 
pointed  surgeon. 

9.  Overalls  shall  be  provided  for  all  persons  employed  in  manipulating  dry 
compounds  of  lead  or  in  pasting. 

The  overalls  shall  be  washed  or  renewed  once  every  week. 

10.  The  occupier  shall  provide  and  maintain — 

(a)  A  cloakroom  in  which  workers  can  deposit  clothing  put  off  during  work- 
ing hours.  Separate  and  suitable  arrangements  shall  be  made  for  the  storage 
of  the  overalls  required  in  regulation  9. 

(6)  A  dining  room  unless  the  factory  is  closed  during  meal  hours. 


344  BEPOETS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

11.  No  person  shall  be  allowed  to  introduce,  keep,  prepare,  or  partake  of  any 
food,  drink,  or  tobacco,  in  any  room  in  which  a  lead  process  is  carried  on. 
Suitable  provision  shall  be  made  for  the  deposit  of  food  brought  by  the  workers. 

This  regulation  shall  not  apply  to  any  sanitary  drink  provided  by  the  occupier 
and  approved  by  the  appointed  surgeon. 

12.  The  occupier  shall  provide  and  maintain  for  the  use  of  the  persons  em- 
ployed in  lead  processes  a  lavatory,  with  soap,  nailbrushes,  towels,  and  at  least 
one  lavatory  basin  for  every  five  such  persons.  Each  such  basin  shall  be  pro- 
vided with  a  waste  pipe,  or  the  basins  shall  be  placed  on  a  trough  fitted  with  a 
waste  pipe.  There  shall  be  a  constant  supply  of  hot  and  cold  water  laid  onto 
each  basin. 

Or,  in  the  place  of  basins  the  occupier  shall  provide  and  maintain  troughs  of 
enamel  or  similar  smooth  impervious  material,  in  good  repair,  of  a  total  length 
of  2  feet  for  every  five  persons  employed,  fitted  with  waste  pipes,  and  without 
plugs,  with  a  sufficient  supply  of  warm  water  constantly  available. 

The  lavatory  shall  be  kept  thoroughly  cleansed  and  shall  be  supplied  with  a 
sufficient  quantity  of  clean  towels  once  every  day. 

13.  Before  each  meal  and  before  the  end  of  the  day's  work,  at  least  ten  min- 
utes, in  addition  to  the  regular  meal  times,  shall  be  allowed  for  washing  to  each 
person  who  has  been  employed  in  the  manipulation  of  dry  compounds  of  lead 
or  in  pasting. 

Provided  that  if  the  lavatory  accommodation  specially  reserved  for  such  per- 
sons exceeds  that  required  by  regulation  12,  the  time  allowance  may  be  pro- 
portionately reduced,  and  that  if  there  be  one  basin  or  2  feet  of  trough  for  each 
such  person  this  regulation  shall  not  apply. 

14.  Sufficient  bath  accommodation  shall  be  provided  for  all  persons  engaged 
in  the  manipulation  of  dry  compounds  of  lead  or  in  pasting,  with  hot  and  cold 
water  laid  on,  and.a  sufficient  supply  of  soap  and  towels. 

This  rule  shall  not  apply  if  in  consideration  of  the  special  circumstances  of 
any  particular  case,  the  chief  inspector  of  factories  approves  the  use  of  local 
public  baths  when  conveniently  near,  under  the  conditions  (if  any)  named  in 
such  approval. 

15.  The  floors  and  benches  of  each  workroom  shall  be  thoroughly  cleansed 
daily  at  a  time  when  no  other  work  is  being  carried  on  in  the  room. 

DUTIES   OF   PERSONS   EMPLOYED. 

16.  All  persons  employed  in  lead  processes  shall  present  themselves  at  the 
appointed  times  for  examination  by  the  appointed  surgeon  as  provided  in  regu- 
lation 8. 

No  person  after  suspension  shall  work  in  a  lead  process,  in  any  factory  or 
workshop  in  which  electric  accumulators  are  manufactured,  without  written 
sanction  entered  in  the  health  register  by  the  appointed  surgeon. 

17.  Every  person  employed  in  the  manipulation  of  dry  comiX)unds  of  lead  or 
in  pasting  shall  wear  the  overalls  provided  under  regulation  9.  The  overalls, 
when  not  being  worn,  and  clothing  put  off  during  working  hours,  shall  be  de- 
posited in  the  places  provided  under  regulation  10. 

18.  No  person  shall  introduce,  keep,  prepare,  or  partake  of  any  food,  drink 
(other  than  any  sanitary  drink  provided  by  the  occupier  and  approved  by  the 
appointed  surgeon),  or  tobacco  in  any  room  in  which  a  lead  process  is 
carried  on. 

19.  No  person  employed  in  a  lead  process  shall  leave  the  premises  or  partake 
of  meals  without  previously  and  carefully  cleaning  and  washing  the  hands. 

20.  Every  person  employed  in  the  manipulation  of  dry  compounds  of  lead  or 
in  pasting  shall  take  a  bath  at  least  once  a  week. 

21.  No  person  shall  in  any  way  interfere,  without  the  concurrence  of  the 
occupier  or  manager,  with  the  means  and  appliances  provided  for  the  removal 
of  the  dust  or  fumes,  and  for  the  carrying  out  of  these  regulations. 

These  regulations  shall  come  into  force  on  the  1st  day  of  January,  1904. 

A.  Akkrs-Douglas, 
One  of  His  Majesty's  Principal  Secretaries  of  State, 
HoMX  Office,  Whitehall,  2Ut  November,  1903, 


REPORTS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  345 

WoEKs  OB  Pabts  of  Woeks,  in  Which  Lead,  Aesenic,  oe  Antimony  is  Used  in 
THK   Enameling  of   Ieon   Plates. 

[Form  251— January,  1906.] 

Duties  of  occupiers. 

1.  They  shall  provide  washing  conveniences  with  a  suflacient  supply  of  hot 
and  cold  water,  soap,  nailbrushes,  and  towels,  and  take  measures  to  secure 
that  every  worker  wash  face  and  hands  before  meals  and  before  leaving  the 
works. 

2.  They  shall  provide  suitable  respirators,  overall  suits,  and  head  coverings 
for  all  workers  employed  in  the  processes  of  grinding,  dusting,  and  brushing. 

3.  They  shall  adopt  measures  on  and  after  the  1st  day  of  October,  1894,  in 
the  dusting  and  brushing  processes  for  the  removal  of  all  superfluous  dust,  by 
the  use  of  perforated  benches  or  tables  supplied  with  fans  to  carry  the  dust 
down  through  the  apertures  of  such  benches  or  tables,  the  underpart  of  which 
must  be  boxed  in. 

4.  They  shall  provide  a  sufficient  supply  of  approved  sanitary  drink,  and  shall 
cause  the  work  people  to  take  it. 

5.  They  shall  arrange  for  a  medical  inspection  of  all  persons  employed,  at 
least  once  a  month. 

They  shall  see  that  no  female  is  employed  without  previous  examination  and 
a  certificate  of  fitness  from  the  medical  attendant  of  the  works. 

They  shall  see  that  no  person  who  has  been  absent  from  work  through  illness 
shall  be  reemployed  without  a  medical  certificate  to  the  effect  that  he  or  she 
has  recovered. 

6.  Upon  any  person  employed  in  the  works  complaining  of  being  unwell,  the 
occupier  shall,  with  the  least  possible  delay,  and  at  his  own  expense,  give  an 
order  upon  a  doctor  for  professional  attendance  and  medicine.  It  is  to  be 
understood  that  this  rule  will  not  apply  to  persons  suffering  from  complaints 
which  have  not  been  contracted  in  the  process  of  manufacture. 

7.  They  shall  provide  a  place  or  places  free  from  dust  and  damp  in  which 
the  operatives  can  hang  up  the  clothes  in  which  they  do  not  work. 

(It  is  recommended  that  they  shall  provide  for  each  female  before  the  day's 
work  begins  some  light  refreshment,  such  as  a  half  pint  of  milk  and  a  biscuit.) 

DUTIES   OF  PEESONS   EMPLOYED. 

8.  Every  person  to  whom  is  supplied  a  respirator  or  overall  and  head  cover- 
ing shall  wear  the  same  when  at  the  work  for  which  such  are  provided. 

9.  Every  person  shall  carefully  clean  and  wash  hands  and  face  before  meals, 
and  before  leaving  the  works. 

10.  No  food  shall  be  eafen  by  any  person  in  any  part  of  the  works  except  in 
the  apartment  specially  provided  for  the  purpose. 

11.  No  person  may  seek  employment  under  an  assumed  name  or  under  any 
false  pretense. 

Respirators. — A  good  respirator  is  a  cambric  bag  with  or  without  a  thin 
flexible  wire  made  to  fit  over  the  nose. 

Sanitary  drink  suggested. — Sulphate  of  magnesia,  2  ounces ;  water,  1  gallon ; 
essence  of  lemon,  sufficient  to  flavor. 

Aethub  Whitelegge, 
His  Majesty's  Chief  Inspector  of  Factories. 

Note. — These  rules  must  be  kept  posted  up  in  conspicuous  places  in  the  fac- 
tory to  which  they  apply,  where  they  may  be  conveniently  read  by  the  persons 
employed.  Any  person  who  is  bound  to  observe  these  rules  and  fails  to  do  so 
or  acts  in  contravention  of  them,  is  liable  to  a  penalty;  and  in  such  case  the 
occupier  also  is  liable  to  a  penalty  unless  he  proves  that  he  has  taken  all 
reasonable  means  by  publishing  and,  to  the  best  of  his  power,  enforcing  the 
rules  to  prevent  the  contravention  or  noncompliance. 


346  REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

WoEKS  IN  Which  Lead  ob  Arsenic  is  Used  in  the  Tinning  and  Enameling  of 
Metal  Hollow  Waee  and  Cooking  Utensils. 

[Form   385 — March,    1906.] 
DUTIES   OF  OCCUPIERS. 

They  shall  provide  washing  conveniences  with  a  sufficient  supply  of  hot  and 
cold  water,  soap,  nailbrushes,  and  towels,  and  take  measures  to  secure  that 
every  worker  wash  face  and  hands  before  meals  and  before  leaving  the  works. 

They  shall  see  that  no  food  is  eaten  in  any  room  where  the  process  of  tinning 
or  enameling  is  carried  on. 

DUTIES   OF   PERSONS   EMPLOYED. 

Every  worker  shall  wash  face  and  hands  before  meals  and  before  leaving 
the  works. 

No  worker  shall  eat  food  in  any  room  where  the  process  of  tinning  or  en- 
ameling is  carried  on. 

Arthur  Whitelegge, 
His  Majesty's  Chief  Inspector  of  Factories. 

Note. — These  rules  must  be  kept  posted  up  in  conspicuous  places  in  the  fac- 
tory to  which  they  apply,  where  they  may  be  conveniently  read  by  the  persons 
employed.  Any  person  who  is  bound  to  observe  these  rules  and  fails  to  do  so 
or  acts  in  contravention  of  them,  is  liable  to  a  penalty,  and  in  such  case  the 
occupier  also  is  liable  to  a  penalty  unless  he  proves  that  he  has  taken  all 
reasonable  means  by  publishing  and,  to  the  best  of  his  power,  enforcing  the 
rules  to  prevent  the  contravention  or  noncompliance. 

Processes  in  the  Manufacture  of  Paints  and  Colors  and  in  the  Extraction 

OF  Arsenic. 

[Form  249 — June,   1904.] 

duties  of  occupiers. 

1.  They  shall  provide  washing  conveniences,  with  a  sufficient  supply  of  hot 
and  cold  water,  soap,  nailbrushes,  and  towels,  and  take  measures  to  secure  that 
every  worker  wash  face  and  hands  before  meals  and  before  leaving  the  works; 
and,  in  addition  to  the  above,  sufficient  bath  accommodation  for  the  use  of  all 
persons  employed  in  the  manufacture  of  Milan  red,  vermilionette,  or  Persian  red, 

2.  They  shall  provide  suitable  respiratcis  and  overall  suits,  kept  in  a  cleanly 
state,  for  all  workers  engaged  in  any  department  w^here  dry  white  lead  or  ar- 
senic is  used  in  either  the  manufacture  or  paint  mixing,  and  overall  suits  for 
.those  engaged  in  grinding  in  water  or  oil,  and  for  all  workers  in  Milan  red, 
vermilionette,  or  Persian  red,  wherever  dust  is  generated. 

3.  They  shall  provide  a  sufficient  supply  of  approved  sanitary  drink,  which 
shall  be  accessible  to  the  workers  at  all  times,  and  shall  cause  such  approved 
sanitary  drink  to  be  taken  daily  by  workers  in  any  department  where  white 
lead  or  arsenic  is  used  in  the  manufacture,  and  shall  provide  a  supply  of 
aperient  medicine,  which  shall  be  given  to  the  workers,  when  required,  free 
of  charge. 

4.  No  food  shall  be  eaten  in  any  part  of  the  works  where  white  lead  or  arsenic 
is  used  in  the  manufacture. 

DUTIES  OF   persons    EMPLOYED. 

5.  Every  person  to  whom  is  supplied  a  respirator  or  overall  suit  shall  wear 
the  same  when  at  the  special  work  for  which  suctf  are  provided. 

6.  Every  person  shall  carefully  clean  and  wash  hands  and  face  before  meals 
and  before  leaving  the  works. 

7.  No  food  shall  be  eaten  in  any  part  of  the  works  in  which  white  lead  or 
arsenic  is  used  in  the  niauufacLure. 


REPORTS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  347 

8.  No  person  shall  smoke  or  use  tobacco  in  any  part  of  the  works  in  which 
white  lead  or  arsenic  is  used  in  the  manufacture. 

Aethur  Whitelegge, 
His  Majesty's  Chief  Inspector  of  Factories, 

Note. — These  rules  must  be  kept  posted  up  in  conspicuous  places  in  the  works 
to  which  they  apply,  where  they  may  be  conveniently  read  by  the  persons  em- 
ployed. Any  person  who  is  bound  to  observe  these  rules  and  fails  to  do  so  or 
acts  in  contravention  of  them,  is  liable  to  a  penalty ;  and  in  such  case  the  occu- 
pier also  is  liable  to  a  penalty  unless  he  proves  that  he  has  taken  all  reasonable 
means  by  publishing  and,  to  the  best  of  his  power,  enforcing  the  rules  to  pre- 
vent the  contravention  or  noncompliance. 

PfiOCESSES  IN  THE  MIXING  AND  CASTING  BrASS,  GUN  MeTAL,  BeLL  MeTAL,  WHITB 

Metal,  Delta  Metal,  Phosphor  Bronze,  and  Manila  Mixture. 

[Form  271 — February,  1904.] 

DUTIES   OF   OCCtrPIERS. 

1.  They  shall  provide  adequate  means  for  facilitating,  as  far  as  possible,  the 
emission  or  escape  from  the  shop  of  any  noxious  fumes  or  dust  arising  from 
the  above-named  processes.  Such  means  shall  include  the  provision  of  traps  or 
of  louver  gratings  in  the  roof  or  ceiling  of  any  shop  in  which  such  processes, 
or  either  of  them,  is  or  are  carried  on ;  or  in  case  of  a  mixing  or  casting  shop 
which  is  situated  under  any  other  shop,  there  shall  be  provided  an  adequate  flue 
or  shaft  (other  than  any  flue  or  shaft  in  connection  with  a  furnace  or  fireplace) 
to  carry  any  fumes  from  the  mixing  or  casting  shop,  by  or  through  any  such 
shop  that  may  be  situated  above  it. 

2.  They  shall  cause  all  such  mixing  or  casting  shops,  whether  defined  as  fac- 
tories or  workshops  under  the  factory  and  workshop  act,  1878,  to  be  cleaned 
down  and  limewashed  once  at  least  within  every  twelve  months,  or  once  within 
every  six  months  is  so  required  by  notice  in  writing  from  His  Majesty's  inspector 
of  factories  and  workshops,  dating  from  the  time  when  these  were  last  thus 
cleaned  down  and  limewashed ;  and  they  shall  record  the  dates  of  such  cleaning 
down  and  limewashing  in  a  prescribed  form  of  register. 

3.  They  shall  provide  a  suflicient  supply  of  metal  basins,  water,  and  soap  for 
the  use  of  all  persons  employed  in  such  mixing  or  casting  shops. 

4.  They  shall  not  employ  or  allow  within  their  factory  or  workshop  the  em- 
ployment of  any  woman  or  female  young  person,  in  any  process  whatever,  in 
any  such  mixing  or  casting  shop,  or  in  any  portion  thereof  which  is  not  entirely 
separated  by  a  partition  extending  from  the  floor  to  the  ceiling. 

DUTIES   OF  PERSONS   EMPLOYED. 

5.  They  shall  not  partake  of  or  cook  any  food  in  any  such  mixing  or  casting 
shop  within  a  period  of  at  least  ten  minutes  after  the  completion  of  the  last 
pouring  of  metal  in  that  shop. 

Arthur  Whitelegge, 
His  Majesty's  Chief  Inspector  of  Factories. 
July  10,  1906. 

Women  and  young  persons  under  18  years  of  age  must  not  be  allowed  to  take 
a  meal  in  any  casting  shop  or  to  remain  there  during  the  time  stated  on  the 
notice  aflixed  in  the  works  as  being  allowed  for  meals. 

These  rules  must  be  kept  posted  up  in  conspicuous  places  in  the  works  to 
which  they  apply,  where  they  may  be  conveniently  read  by  the  persons  em- 
ployed. 

Any  person  who  is  bound  to  observe  these  rules  and  fails  to  do  so  or  acts  in 
contravention  of  them,  is  liable  to  a  penalty ;  and  in  such  case  the  occupier  also 
is  liable  to  a  penalty  unless  he  proves  that  he  has  taken  all  reasonable  means, 
by  publishing  and  to  the  best  of  his  power  enforcing  the  rules,  to  prevent  the 
contravention  or  noncompliance. 


348  EEPOETS  OF   THE  PRESIDENT'S  HOMES   COMMISSION. 

Chemical  Works. 
[Form  258 — Reprinted  December,  1901.1 

1.  In  future  every  uncovered  pot,  pan,  or  other  structure  containing  liquid 
of  a  dangerous  character,  shall  be  so  constructed  as  to  be  at  least  3  feet  in 
height  above  the  ground  or  platform.  Those  already  in  existence  which  are  less 
than  3  feet  in  height,  or  in  cases  where  it  is  proved  to  the  satisfaction  of  an 
inspector  that  a  height  of  3  feet  is  impracticable,  shall  be  securely  fenced. 

2.  There  shall  be  a  clear  space  around  such  pots,  pans,  or  other  structures,  or 
where  any  junction  exists  a  barrier  shall  be  so  placed  as  to  prevent  passage. 

3.  Caustic  pots  shall  be  of  such  construction  that  there  shall  be  no  footing  on 
the  top  or  sides  of  the  brickwork,  and  dome-shaped  lids  shall  be  used  where 
possible. 

4.  No  unfenced  planks  or  gangways  shall  be  placed  across  open  pots,  pans,  or 
other  structures  containing  liquid  of  a  dangerous  character.  This  rule  shall 
not  apply  to  black  ash  vats  where  the  vats  themselves  are  otherwise  securely 
fastened. 

5.  Suitable  respirators  shall  be  provided  for  the  use  of  the  workers  in  places 
where  poisonous  gases  or  injurious  dust  may  be  inhaled. 

6.  The  lighting  of  all  dangerous  places  shall  be  made  thoroughly  efficient. 

7.  Every  place  where  caustic  soda  or  caustic  potash  is  manufactured  shall 
be  supplied  with  syringes  or  wash  bottles,  which  shall  be  inclosed  in  covered 
boxes  fixed  in  convenient  places,  in  the  proportion  of  one  to  every  four  caustic 
pots.  They  shall  be  of  suitable  form  and  size,  and  be  kept  full  of  clean  water. 
Similar  appliances  shall  be  provided  wherever,  in  the  opinion  of  an  inspector, 
they  may  be  desirable. 

8.  Overalls,  kept  in  a  cleanly  state,  shall  be  provided  for  all  workers  in  any 
room  where  chlorate  of  potash  or  other  chlorate  is  ground.  In  every  such  room 
a  bath  shall  be  kept  ready  for  immediate  use. 

In  every  chlorate  mill,  tallow  or  other  suitable  lubricant  shall  be  used  In- 
stead of  oil. 

9.  Respirators  charged  with  moist  oxide  of  iron  or  other  suitable  substance, 
shall  be  kept  in  accessible  places  ready  for  use  in  cases  of  emergency  arising 
from  the  sulphuretted  hydrogen  or  other  poisonous  gases. 

10.  In  salt  cake  departments  suitable  measures  shall  be  adopted  by  maintain- 
ing a  proper  draft  and  by  other  means  to  obviate  the  escape  of  low-level  gases. 

11.  Wei  don  bleaching  powder  chambers,  after  the  free  gas  has,  as  far  as  may 
be  practicable,  been  drawn  off  or  absorbed  by  fresh  lime,  shall,  before  being 
opened,  be  tested  by  the  standard  recognized  under  the  alkali  act.  Such  tests 
shall  be  duly  entered  in  a  register  kept  for  the  purpose. 

All  chambers  shall  be  ventilated  as  far  as  possible,  when  packing  is  being 
carried  on,  by  means  of  open  doors  on  opposite  sides  and  openings  in  the  roof 
so  as  to  allow  of  a  free  current  of  air. 

12.  In  cases  where  the  cooperation  of  the  workers  is  required  for  carrying  out 
the  foregoing  rules,  and  where  such  cooperation  is  not  given,  the  workers  shall 
be  held  liable  in  accordance  with  the  factory  and  workshop  act,  1S91,  section 
9,  which  runs  as  follows :  "If  any  person  who  is  bound  to  observe  any  special 
rules,  established  for  any  factory  or  workshop  under  this  act,  acts  in  contra- 
vention of,  or  fails  to  comply  with,  any  such  special  rule,  he  shall  be  liable  on 
summary  conviction  to  a  fine  not  exceeding  £2  ($0.73)." 

Arthur  Whitelegge, 
His  Majesty's  Chief  Inspector  of  Factories. 

Amended  Special  Rules  for  Chemical  Works  in  Which  is  Carried  on  the 
Manufacture  op  Bichromate  or  Chromate  of  Potassium  or  Sodium. 

[Form  260— January,  1906.] 

In  these  rules  "  persons  employed  In  a  chromo  process  "  means  a  person  who 
Is  employed  in  any  work  involving  contact  with  chromate  or  bichromate  of 
potassium  or  sodium,  or  involving  exposure  to  dust  or  fumes  arising  from  the 
manufacture  thereof. 

Any  approval  given  by  the  chief  inspector  in  pursuance  of  rule  10  shall  be 
givra  In  writing,  and  may  at  any  time  be  revoked  by  notice  in  writing  signed 
by  him. 


BEPORTS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  349 

DUTIES   OF  OCCTJPIEES. 

1  No  uncovered  pot,  pan,  or  other  structure  containing  liquid  of  a  dangerous 
character  shall  be  so  constructed  as  to  be  less  than  3  feet  in  height  above  the 
adjoining  ground  or  platform.  ^  ^  ^  ^ 

This  rule  shall  not  apply  to  any  pot,  pan,  or  other  structure  constructed  before 
January  1,  1899,  or  in  which  a  height  of  3  feet  is  impracticable  by  reason  of  the 
nature  of  the  work  to  be  carried  on,  provided  in  either  case  that  the  structure 
is  securely  fenced. 

2.  There  shall  be  a  clear  space  round  all  pots,  pans,  or  other  structures  con- 
taining liquid  of  a  dangerous  character,  except  where  any  junction  exists,  in 
which  case  a  barrier  shall  be  so  placed  as  to  prevent  passage. 

3.  No  unfenced  plank  or  gangway  shall  be  placed  across  any  pot,  pan,  or 
other  structure  containing  liquid  of  a  dangerous  character. 

4.  The  lighting  of  all  dangerous  places  shall  be  made  thoroughly  efficient. 

5.  The  grinding,  separating,  and  mixing  of  the  raw  materials  (including 
chrome  ironstone,  lime,  and  sodium  and  potassium  carbonate)  shall  not  be  done 
without  such  appliances  as  will  prevent,  as  far  as  possible,  the  entrance  of  dust 
into  the  workrooms. 

6.  **  Batches,"  when  withdrawn  from  the  furnaces,  shall  either  be  placed  in 
the  keaves  or  vats  while  still  warm,  or  be  allowed  to  cool  in  barrows  or  other 
receptacles. 

7.  Evaporating  vessels  shall  be  covered  in,  and  shall  be  provided  with  ventilat- 
ing shafts  to  carry  the  steam  into  the  outside  air. 

8.  Packing  or  crushing  of  bichromate  of  potassium  or  sodium  shall  not  be 
done  except  under  conditions  which  secure  either  the  entire  absence  of  dust  or 
its  effectual  removal  by  means  of  a  fan. 

9.  No  child  or  young  person  shall  be  employed  in  a  chrome  process. 

10.  The  occupier  shall,  subject  to  the  approval  of  the  chief  inspector,  appoint 
a  duly  qualified  medical  practitioner  (in  these  rules  referred  to  as  the  appointed 
surgeon),  who  shall  examine  all  persons  employed  in  chrome  processes  at  least 
once  in  every  month,  and  shall  undertake  any  necessary  medical  treatment  of 
disease  contracted  in  consequence  of  such  employment,  and  shall,  after  the  30th 
day  of  April,  1900,  have  power  to  suspend  any  such  person  from  work  in  any 
place  or  process. 

(&)  No  person  after  such  suspension  shall  be  employed  in  any  chrome  process 
without  the  written  sanction  of  the  appointed  surgeon. 

(c)  A  register  shall  be  kept  in  a  form  approved  by  the  chief  inspector,  and 
shall  contain  a  list  of  all  persons  employed  in  any  chrome  process.  The  ap- 
pointed surgeons  shall  enter  in  the  register  the  dates  and  results  of  his  exami- 
nations of  the  persons  employed  and  particulars  of  any  treatment  prescribed 
by  him.  The  register  shall  be  produced  at  any  time  when  required  by  His 
Majesty's  inspectors  of  factories  or  by  the  appointed  surgeon. 

11.  Requisites  (approved  by  the  appointed  surgeon)  for  treating  slight 
wounds  and  ulcers  shall  be  kept  at  hand  and  be  placed  in  charge  of  a  re- 
sponsible person. 

12.  The  occupier  shall  provide  sufficient  and  suitable  overall  suits  for  the 
use  of  all  persons  engaged  in  the  processes  of  grinding  the  raw  materials,  and 
sufficient  and  suitable  overall  suits  or  other  adequate  means  of  protection 
approved  in  writing  by  the  appointed  surgeon,  for  the  use  of  all  persons  en- 
gaged in  the  crystal  department  or  in  packing. 

Respirators  approved  by  the  appointed  surgeon  shall  be  provided  for  the 
use  of  all  persons  employed  in  packing  or  crushing  bichromate  of  sodium  or 
potassium. 

At  the  end  of  every  day's  work  they  shall  be  collected  and  kept  in  proper 
custody  in  a  suitable  place  set  apart  for  the  purpose. 

The  overalls  and  respirators  shall  be  thoroughly  washed  or  renewed  every 
week. 

13.  The  occupier  shall  provide  and  maintain  a  cloakroom  in  which  workers 
can  deposit  clothing  put  off  during  working  hours. 

14.  The  occupier  shall  provide  and  maintain  a  lavatory  for  the  use  of  the 
persons  employed  in  chrome  processes;  with  soap,  nailbrushes,  and  towels,  and 
a  constant  supply  of  hot  and  cold  water  laid  onto  each  basin.  There  shall  be 
at  least  one  lavatory  basin  for  every  five  persons  employed  in  the  crystal  de- 
partment and  in  packing.  Each  srcli  basin  shall  be  fitted  with  a  waste  pipe, 
or  shall  be  placed  in  a  trough  fitted  with  waste  pipe. 


350  REPORTS   OF    THE   PRESIDENT'S   HOMES   COMMISSION. 

15.  The  occupier  shall  provide  and  maintain  sufficient  baths  and  dressing 
rooms  for  all  persons  employed  in  chrome  processes,  with  hot  and  cold  water 
laid  on,  and  a  sufficient  supply  of  soap  and  towels ;  and  shall  cause  each  person 
employed  in  the  crystal  department  and  in  packing  to  take  a  bath  once  a 
week  at  the  factory. 

A  bath  register  shall  be  kept  containing  a  list  of  all  persons  employed  in  the 
crystal  department  and  in  packing,  and  an  entry  of  the  date  when  each  person 
takes  a  bath. 

The  bath  register  shall  be  produced  at  any  time  when  required  by  His 
Majesty's  inspectors  of  factories. 

16.  The  floors,  stairs,  and  landings  shall  be  cleaned  daily. 

DUTIES   OF   PERSONS   EMPLOYED. 

17.  No  person  shall  deposit  a  "  batch "  when  withdrawn  from  the  furnace 
upon  the  floor  nor  transfer  it  to  the  keaves  or  vats  otherwise  than  as  prescribed 
in  rule  6. 

18.  No  person  shall  pack  or  crush  bichromate  of  potassium  or  sodium  other- 
wise than  as  prescribed  in  rule  8. 

19.  (a)  Every  person  employed  in  a  chrome  process  shall  present  himself  at 
the  appointed  times  for  examination  by  the  appointed  surgeon  as  provided  in 
rule  10. 

( 6 )  After  the  30th  day  of  April,  1900,  no  person  suspended  by  the  appointed 
surgeon  shall  work  in  a  chrome  process  without  his  written  sanction. 

20.  Every  person  engaged  in  the  processes  of  grinding  the  raw  materials  shall 
wear  an  overall  suit,  and  every  person  engaged  in  the  crystal  department  or 
in  packing  shall  wear  an  overall  suit  or  other  adequate  means  of  protection 
approved  by  the  appointed  surgeon. 

Every  person  employed  in  packing  or  crushing  bichromate  of  sodium  or 
potassium  shall  in  addition  wear  a  respirator  while  so  occupied. 

21.  Every  person  employed  in  the  processes  named  in  rule  20  shall  before 
leaving  the  premises  deposit  the  overalls  and  respirators  in  the  place  appointed 
by  the  occupier  for  the  purpose,  and  shall  thoroughly  wash  face  and  hands  in 
the  lavatory. 

22.  Every  person  employed  in  the  crystal  department  and  in  the  packing  shall 
take  a  bath  at  the  factory  at  least  once  a  week ;  and,  having  done  so,  shall  at 
once  sign  his  name  in  the  bath  register,  with  the  date. 

23.  The  foreman  shall  report  to  the  manager  any  instance  coming  under  his 
notice  of  a  workman  neglecting  to  observe  these  rules. 

Arthur  Whitelegge, 
Chief  Inspector  of  Factories, 
M.  W.  Ridley, 
One  of  Her  Majesty's  Principal  Secretaries  of  State. 
February,  1900. 

Note. — These  rules  must  be  kept  posted  up  in  conspicuous  places  in  the  fac- 
tory to  which  they  apply,  where  they  may  be  conveniently  read  by  the  persons 
employed.  Any  person  who  is  bound  to  observe  these  rules  and  fails  to  do  so 
or  acts  in  contravention  of  them,  is  liable  to  penalty;  and  in  such  cases  the 
occupier  also  is  liable  to  a  penalty  unless  he  proves  that  he  has  taken  all  rea- 
sonable means  by  publishing  and,  to  the  best  of  his  power,  enforcing  the  rules, 
to  prevent  the  contravention  or  noncompliance. 

Manutactuee  of  Explosives  in  which  Di-Nitro-Benzole  is  Used. 
[Form  257 — December,  1904.] 

1.  No  person  to  be  employed  without  a  medical  certificate,  stating  that  he 
or  she  is  physically  fit  for  such  employment. 

2.  An  examination  of  the  workers  at  their  work  to  be  made  at  least  once  a 
fortnight  by  a  certifying  surgeon,  who  shall  have  power  to  order  temporary  sus- 
pension or  total  change  of  work  for  any  person  showing  symptoms  of  suffering 
from  the  poison,  or  if  after  a  fair  trial  he  is  of  opinion  that  any  person  is  by 
constitution  unfit,  he  shall  direct  that  such  person  shall  cease  to  be  employed. 

3.  A  supply  of  fresh  milk,  and  of  any  drug  that  the  medical  officer  may  con- 
sider desirable,  shall  be  kept  where  the  workers  in  his  opinion  may  require  it. 

4.  No  meals  to  be  taken  in  the  workrooms. 


REPORTS   OF   THE  PRESIDENT'S  HOMES   COMMISSION.  351 

5.  There  shall  be  provided  separate  lavatories  for  men  and  women,  with  a 
good  supply  of  hot  water,  soap,  nailbrushes,  and  towels,  and  whenever  the  skin 
has  come  in  contact  with  di-nitro-benzole,  the  part  shall  be  immediktely  washed. 

6.  Overall  suits  and  head  coverings  shall  be  supplied  to  all  workers  in  shops 
where  di-nitro-benzole  is  used,  these  suits  to  be  taken  off  or  well  brushed  before 
meals  and  before  leaving  the  works,  and  to  be  washed  at  least  once  a  week. 

7.  Suitable  respirators  (capable  of  being  washed),  folds  of  linen,  or  woolen 
material  of  open  texture,  or  other  suitable  material,  shall  be  supplied  to  those 
workers  liable  to  inhale  dust,  and  the  wearing  of  such  respirators  shall  be 
urged  where  the  workers  derive  benefit  from  their  use. 

8.  Where  di-nitro-benzole  has  to  be  handled,  the  hands  shall  always  be  pro- 
tected from  direct  contact  with  it,  either  by  the  use  of  india-rubber  gloves  (kept 
perfectly  clean,  especially  in  the  inner  side),  or  by  means  of  rags  which  shall 
be  destroyed  immediately  after  use. 

9.  Where  di-nitro-benzole  is  broken  by  hand,  the  instrument  used  shall  be  a 
wooden  bar,  spade,  or  tool  with  a  handle  long  enough  to  prevent  the  worker's 
face  from  coming  into  contact  with  the  material. 

10.  In  all  rooms  or  sheds  in  which  the  process,  either  of  purifying,  grinding,  or 
mixing  materials  of  which  di-nitro-benzole  forms  a  part,  is  carried  on,  efficient 
"  cowls,"  ventilating  shafts,  and  mechanical  ventilating  fans  shall  be  provided 
to  carry  off  the  dust  or  fumes  generated. 

11.  Drying  stoves  shall  be  efficiently  ventilated,  and,  when  possible,  be 
charged  and  drawn  at  fixed  times,  and  a  free  current  of  air  shall  be  admitted 
for  some  time  prior  to  the  workers  entering  to  draw  either  a  part  or  the  whole 
of  the  contents. 

12.  In  the  process  of  filling  cartridges,  the  material  shall  not  be  touched  by 
hand,  but  suitable  scoops  shall  be  used,  and  where  patent  ventilated  cartridge- 
filling  machines  are  not  used,  there  shall  be  efficient  mechanical  ventilation 
arranged  in  such  a  manner  that  the  suction  shall  draw  the  fumes  or  dust  away 
from  and  not  across  or  over  the  faces  of  the  workers. 

13.  A  register,  in  a  prescribed  form,  shall  be  kept,  and  it  shall  be  the  duty  of 
a  responsible  person  named  by  the  firm  to  enter,  at  least  once  a  week,  a  state- 
ment that  he  has  personally  satisfied  himself  that  each  and  all  of  the  special 
rules  have  been  observed,  or  if  not,  the  reason  for  such  nonobservance.  The 
surgeon  to  enter  in  this  register  the  dates  of  his  visits,  the  results  of  such  visits, 
and  any  requirements  made  by  him. 

14.  The  "  dipping  "  rooms  to  be  efficiently  ventilated. 

Arthur  Whitelegge, 
His  Majesty's  Chief  Inspector  of  Factories. 

Note. — These  rules  must  be  kept  posted  up  in  conspicuous  places  in  the  fac- 
tory to  which  they  apply,  where  they  may  be  conveniently  read  by  the  persons 
employed.  Any  person  who  is  bound  to  observe  these  rules  and  fails  to  do  so  or 
acts  in  contravention  of  them,  is  liable  to  a  penalty;  and  in  such  case  the  occu- 
pier also  is  liable  to  a  penalty  unless  he  proves  that  he  has  taken  all  reasonable 
means  by  publishing  and,  to  the  best  of  his  power,  enforcing  the  rules,  to  pre- 
vent the  contravention  or  noncompliance. 

Vulcanizing  of  India  Rubber  by  Means  of  Bisulphide  of  Carbon. 
[Form  274 — October,  1906.] 
I. — DUTIES   OF   employers. 

1.  No  child  or  young  person  shall  be  employed  in  any  room  in  which  bisul- 
phide of  carbon  is  used. 

2.  After  May  1,  1898,  no  person  shall  be  employed  for  more  than  five  hours 
in  any  day  in  a  room  in  which  bisulphide  of  carbon  is  used,  nor  for  more  than 
two  and  a  half  hours  at  a  time  without  an  interval  of  at  least  an  hour. 

3.  In  vulcanizing  waterproof  cloth  by  means  of  bisulphide  of  carbon — (a)  the 
trough  containing  the  bisulphide  of  carbon  shall  be  self-feeding  and  covered  over ; 

(&)  the  cloth  shall  be  conveyed  to  and  from  the  drying  chamber  by  means  of  an 
automatic  machine;  (c)  no  person  shall  be  allowed  to  enter  the  drying  chamber 
in  the  ordinary  course  of  work;  {d)  the  machine  shall  be  covered  over  and  the 
fumes  drawn  away  from  the  workers  by  means  of  a  downward-suction  fan 
maintained  in  constant  efficiency. 

4.  Dipping  shall  not  be  done  except  in  boxes  so  arranged  that  a  suction  fan 
shall  draw  the  fumes  away  from  the  workers. 


352  EEPOETS  OF  THE  PRESIDENT'S  HOMES  COMMISSION. 

5.  No  food  shall  be  allowed  to  be  eaten  in  any  room  in  which  bisulphide  of 
carbon  is  used. 

6.  A  suitable  place  for  meals  shall  be  provided. 

7.  All  persons  employed  in  rooms  in  which  bisulphide  of  carbon  is  used  shall 
be  examined  once  a  month  by  the  certifying  surgeon  for  the  district,  who  shall, 
after  May  1, 1898,  have  power  to  order  temporary  or  total  suspension  from  work. 

8.  No  person  shall  be  employed  in  any  room  in  which  bisulphide  of  carbon  is 
used  contrary  to  the  direction  of  the  certifying  surgeon  given  as  above. 

9.  A  register  in  the  form  which  has  been  prescribed  by  the  secretary  of  state 
for  use  in  india-rubber  works  shall  be  kept,  and  in  it  the  certifying  surgeon  will 
enter  the  dates  and  result  of  his  visits,  with  the  number  of  persons  examined, 
and  particulars  of  any  directions  given  by  him.  This  register  shall  contain  a 
list  of  all  persons  employed  in  rooms  in  which  bisulphide  of  carbon  is  used,  and 
shall  be  produced  at  any  time  when  required  by  His  Majesty's  inspector  of  fac- 
tories or  by  the  certifying  surgeon. 

II. — DUTIES  OF  PERSONS  EMPLOYED. 

10.  No  person  shall  enter  the  drying  room  in  the  ordinary  course  of  work,  or 
perform  dipping  except  in  boxes  provided  with  a  suction  fan  carrying  the  fumes 
away  from  the  workers. 

11.  No  person  shall  take  any  food  in  any  room  in  which  bisulphide  of  carbon 
is  used. 

12.  After  May  1, 1898,  no  person  shall,  contrary  to  the  direction  of  the  certify- 
ing surgeon,  given  in  pursuance  of  rule  7,  work  in  any  room  in  which  bisulphide 
of  carbon  is  used. 

13.  All  persons  employed  in  rooms  in  which  bisulphide  of  carbon  is  used  shall 
present  themselves  for  periodic  examination  by  the  certifying  surgeon,  as  pro- 
vided in  rule  7. 

14.  It  shall  be  the  duty  of  all  persons  employed  to  report  immediately  to  the 
employer  or  foreman  any  defect  which  they  may  discover  in  the  working  of  the 
fan  or  in  any  appliance  required  by  these  rules. 

Arthub  Whitelegge, 
His  Majesty's  Chief  Inspector  of  Factories. 

Note. — These  rules  are  required  to  be  posted  up  in  conspicuous  places  in  the 
factory  or  workshop  to  which  they  apply,  where  they  may  be  conveniently  read 
by  the  persons  employed.  Any  person  who  willfully  injures  or  defaces  them  is 
liable  to  a  penalty  not  exceeding  £5  ($24.33).  Occupiers  of  factories  and  work- 
shops, and  persons  employed  therein,  who  are  bound  to  observe  these  rules,  are 
liable  to  penalties  in  case  of  noncompliance.  ( Factory  and  workshop  act,  1891, 
sec.  9,  and  factory  and  workshop  act,  1901,  sees.  85  and  86. ) 

Lucifer-Match  Factories  in  Which  White  or  Yellow  Phosphorus  is  Used. 
[Form  384 — January,  1904.] 

In  these  rules  "  phosphorous  process  "  means  mixing,  dipping,  drying,  boxing, 
and  any  other  work  or  process  in  which  white  or  yellow  phosphorus  is  used ;  and 
"  person  employed  in  a  phosphorous  process  "  means  any  person  who  is  employed 
in  any  room  or  part  of  the  factory  where  such  a  process  is  carried  on. 

"  Double-dipped  matches  "  means  wood  splints,  both  ends  of  which  have  been 
dipped  in  the  igniting  composition. 

"  Certifying  surgeon  "  means  a  surgeon  appointed  under  the  factory  and  work- 
shop acts. 

Any  approval  or  decision  given  by  the  chief  inspector  of  factories  in  pursuance 
of  these  rules  shall  be  given  in  writing,  and  may  at  any  time  be  revoked  by  notice 
in  writing  signed  by  him. 

Rules^5  (a),  5  (&),  6,  8,  and  19,  so  far  as  they  affect  the  employment  of  adult 
workers,  shall  not  come  into  force  until  the  1st  day  of  October,  1900. 

duties  of  employers. 

1.  No  part  of  a  luclfer-match  factory  shall  be  constructed,  structurally  altered, 
or  newly  used,  for  the  carrying  on  of  any  phosphorous  process,  unless  the  plans 
have  previously  been  submitted  in  duplicate  to  the  chief  inspector  of  factories, 
and  unless  he  shall  have  approved  the  plans  in  writing,  or  shall  not  within  six 


EEPORTS   OF   THE  PKESIDENT's  HOMES  COMMISSION.  353 

weeks  from  the  submission  of  the  plans  haye  expressed  his  disapproval  in  writing 
of  the  same. 

2.  Every  room  in  which  mixing,  dipping,  drying,  or  boxing  is  carried  on  shall 
be  efficiently  ventilated  by  means  of  sufllcient  openings  to  the  outer  air,  and  also 
by  means  of  fans,  unless  the  use  of  fans  is  dispensed  with  by  order  in  writing  of 
the  chief  inspector;  shall  contain  at  least  400  cubic  feet  of  air  space  for  each 
person  employed  therein;  and  in  computing  this  air  space  no  height  above  14 
feet  shall  be  taken  into  account;  shall  be  efficiently  lighted;  shall  have  a 
smooth  and  impervious  floor.  A  floor  laid  with  flagstone  or  hard  bricks  in  good 
repair  shall  be  deemed  to  constitute  a  smooth  and  impervious  floor. 

3.  (a)  The  processes  of  mixing,  dipping,  and  drying  shall  each  be  done  in  a 
separate  and  distinct  room.  The  process  of  boxing  double-dipped  matches  or 
matches  not  thoroughly  dry  shall  also  be  done  in  a  separate  and  distinct  room. 
These  rooms  shall  not  communicate  with  any  other  part  of  the  factory  unless 
there  shall  be  a  ventilated  space  intervening;  nor  shall  they  communicate  with 
one  another,  except  by  means  of  doorways  with  closely  fitting  doors,  which 
doors  shall  be  kept  shut  except  when  some  person  is  passing  through. 

(&)  Mixing  shall  not  be  done  except  in  an  apparatus,  or  so  arranged  and 
ventilated  by  means  of  a  fan  as  to  prevent  the  entrance  of  fumes  into  the  air 
of  the  mixing  room. 

(c)  Dipping  shall  not  be  done  except  on  a  slab  provided  with  an  efficient 
exhaust  fan,  and  with  an  air  inlet  between  the  dipper  and  the  slab,  or  with  a 
hood  so  arranged  as  to  draw  the  fumes  away  from  the  dipper  and  to  prevent 
them  from  entering  the  air  of  the  dipping  room. 

(d)  Matches  that  have  been  dipped  and  can  not  at  once  be  removed  to  the 
drying  room  shall  immediately  be  placed  under  a  hood  provided  with  an  effi- 
cient exhaust  fan,  so  arranged  as  to  prevent  the  fumes  from  entering  the  air 
of  the  room. 

(e)  Matches  shall  not  be  taken  to  a  boxing  room  not  arranged  in  compliance 
with  subsection  (/)  of  this  rule  until  they  are  thoroughly  dry,  and  matches  shall 
not  be  taken  to  a  boxing  room  that  is  so  arranged  until  they  are  dried  so  far 
as  they  can  be  before  cutting  down  and  boxing. 

(/)  Cutting  down  of  double-dipped  matches  and  boxing  of  matches  not  thor- 
oughly dry  shall  not  be  done  except  at  benches  or  tables  provided  with  an  effi- 
cient exhaust  fan,  so  arranged  as  to  draw  the  fumes  away  from  the  worker  and 
prevent  them  from  entering  the  air  of  the  boxing  room. 

Provided,  that  the  foregoing  rule  shall  not  prevent  the  employment  of  any 
mechanical  arrangement  for  carrying  on  any  of  the  above-mentioned  processes 
if  the  same  be  approved  by  the  chief  inspector  as  obviating  the  use  of  hand 
labor,  and  if  it  be  used  subject  to  the  conditions  (if  any)  specified  in  such 
approval. 

Provided  further,  that  If  the  chief  inspector  shall,  on  consideration  of  the 
special  circumstances  of  any  particular  case,  so  approve  in  writing,  all  or  any 
of  the  provisions  of  the  foregoing  rule  may  be  suspended  for  the  time  named 
in  such  approval  in  writing. 

4.  Vessels  containing  phosphorous  paste  shall,  when  not  actually  in  use,  be 
kept  constantly  covered,  and  closely  fitting  covers  or  damp  flannels  shall  be 
provided  for  the  purpose. 

5.  (a)  For  the  purpose  of  these  rules  the  occupier  shall  appoint,  subject  to 
the  approval  of  the  chief  inspector,  a  duly  qualified  and  registered  dentist, 
herein  termed  the  "  appointed  dentist." 

It  shall  be  the  duty  of  the  appointed  dentist  to  suspend  from  employment  in 
any  phosphorous  process  any  person  whom  he  finds  to  incur  danger  of  phos- 
phorous necrosis  by  reason  of  defective  conditions  of  teeth  or  exposure  of 
the  jaw. 

(6)  No  person  shall  be  newly  employed  in  a  dipping  room  for  more  than 
twenty-eight  days,  whether  such  days  are  consecutive  or  not,  without  being 
examined  by  the  appointed  dentist. 

(c)  Every  person  employed  in  phosphorous  process,  except  persons  employed 
only  as  boxers  of  wax  vestas  or  other  thoroughly  dry  matches,  shall  be  exam- 
ined by  the  appointed  dentist  at  least  once  in  every  three  months. 

(d)  Any  person  employed  in  the  factory  complaining  of  tootache,  or  a  pain 
or  swelling  of  the  jaw,  shall  at  once  be  examined  by  the  appointed  dentist. 

(e)  When  the  appointed  dentist  has  reason  to  believe  that  any  person  em- 
ployed in  the  factory  is  suffering  from  inflammation  or  necrosis  of  the  jaw,  or 
is  in  such  a  state  of  health  as  to  incur  danger  of  phosphorous  necrosis,  he  shall 

S.  Doc.  644,  60-2 ^24 


354  REPORTS  OP   THE  PRESIDENT'S  HOMES  COMMISSION. 

at  once  direct  the  attention  of  the  certifying  surgeon  and  occupier  to  the  case. 
Thereupon  such  person  shall  at  once  be  examined  by  the  certifying  surgeon. 

6.  No  person  shall  be  employed  in  a  phosphorous  process  after  suspension  by 
the  appointment  dentist,  or  after  the  extraction  of  a  tooth,  or  after  any  opera- 
tion involving  exposure  of  the  jawbone,  or  after  inflammation  or  necrosis  of 
the  jaw,  or  after  examination  by  the  appointed  dentist  in  pursuance  of  rule  5 
(d),  or  after  reference  to  the  certifying  surgeon  in  pursuance  of  rule  5  (e), 
unless  a  certificate  of  fitness  has  been  given,  after  examination,  by  signed  entry 
in  the  health  register,  by  the  appointed  dentist  or  by  the  certifying  surgeon  in 
cases  referred  to  him  under  rule  5  (e). 

7.  A  health  register,  in  a  form  approved  by  the  chief  inspector  of  factories, 
shall  be  kept  by  the  occupier,  and  shall  contain  a  complete  list  of  all  persons 
employed  in  each  phosphorous  process,  specifying  with  regard  to  each  such  per- 
son the  full  name,  address,  age  when  first  employed,  and  date  of  first  em- 
ployment. 

The  certifying  surgeon  will  enter  in  the  health  register  the  dates  and  results 
of  his  examinations  of  persons  employed  in  phosphorous  processes,  and  particu- 
lars of  any  directions  given  by  him. 

The  appointed  dentist  will  enter  in  the  health  register  the  dates  and  results 
of  his  examinations  of  the  teeth  of  persons  employed  in  phosphorous  processes, 
and  particulars  of  any  directions  given  by  him,  and  a  note  of  any  case  referred 
by  him  to  the  certifying  surgeon. 

The  health  register  shall  be  produced  at  any  time  when  required  by  His 
Majesty's  inspectors  of  factories,  or  by  the  certifying  surgeon,  or  by  the  ap- 
pointed dentist. 

8.  Except  persons  whose  names  are  on  the  health  register  mentioned  in  rule 
7,  and  in  respect  of  whom  certificates  of  fitness  shall  have  been  granted,  no 
person  shall  be  newly  employed  in  any  phosphorous  process  for  more  than 
twenty-eight  days,  whether  such  days  are  consecutive  or  not,  without  certificate 
of  fitness,  granted  after  examination  by  the  certifying  surgeon,  by  signed  entry 
in  the  health  register. 

This  rule  shall  not  apply  to  persons  employed  only  as  boxers  of  wax  vestas 
«T  other  thoroughly  dry  matches. 

9.  The  occupier  shall  provide  and  maintain  sufficient  and  suitable  overalls  for 
all  persons  employed  in  phosphorous  processes,  except  for  persons  employed  only 
us  boxes  of  wax  vestas  or  other  thoroughly  dry  matches,  and  shall  cause  them 
to  be  worn  as  directed  in  rule  20. 

At  the  end  of  every  day's  work  they  shall  be  collected  and  kept  in  proper 
custody  in  a  suitable  place  set  apart  for  the  purpose. 

They  shall  be  thoroughly  washed  every  week,  and  suitable  arrangements  for 
this  purpose  shall  be  made  by  the  occupier. 

10.  The  occupier  shall  provide  and  maintain  (a)  a  dining  room,  and  (6)  a 
cloakroom  in  which  workers  can  deposit  clothing  put  off  during  working  hours. 

11.  No  person  shall  be  allowed  to  prepare  or  partake  of  any  food  or  drink  in 
any  room  in  which  phosphorous  process  is  carried  on,  nor  to  bring  any  food  or 
drink  into  such  room. 

12.  The  occupier  shall  provide  and  maintain  for  the  use  of  the  workers  a 
lavatory,  with  soap,  nailbrushes,  towels,  and  at  least  one  lavatory  basin  for 
every  five  persons  employed  in  any  phosphorous  process. 

Each  such  basin  shall  be  fitted  with  waste  pipe.  There  shall  be  a  constant 
supply  of  hot  and  cold  water  laid  onto  each  basin. 

Or,  in  the  place  of  basins,  the  occupier  shall  provide  and  maintain  enamel  or 
galvanlzed-iron  troughs,  in  good  repair,  of  a  total  length  of  2  feet  for  every  five 
persons  employed,  fitted  with  waste  pipes  and  without  plugs,  with  a  sufficient 
supply  of  warm  water  constantly  available. 

The  lavatory  shall  be  kept  thoroughly  cleansed,  and  shall  be  supplied  with  a 
sufficient  quantity  of  clean  towels  twice  in  each  day. 

There  shall,  in  addition,  be  means  of  washing  in  close  proximity  to  the 
workers  In  any  department,  if  so  required  in  writing  by  the  inspector  in  charge 
of  the  district. 

13.  The  occupier  shall  provide  for  the  use  of  every  person  employed  in  a 
phosphorous  process  an  antiseptic  mouth  wash  approved  by  the  appointed 
dentist,  and  a  sufficient  supply  of  glasses  or  cups. 

14.  The  floor  of  each  room  in  which  a  phosphorous  process  is  carried  on  shall 
be  cleared  of  waste  at  least  once  a  day,  and  washed  at  least  once  a  week. 

15.  A  printed  copy  of  these  rules  shall  be  given  to  eacli  person  on  entering 
iip<m  employment  in  a  phosphorous  process. 


EEPOETS   OP   THE  PRESIDENT'S  HOMES   COMMISSION.  355 

DUTIES   OF  PEESONS  EMPLOYED. 

16.  No  person  shall  work  in  a  mixing,  dipping,  drying,  or  boxing  room  under 
other  conditions  than  those  prescribed  in  rule  3. 

17.  No  person  shall  allow  a  vessel  containing  phosphorous  paste  to  remain 
uncovered  except  when  actually  in  use. 

18.  All  persons  employed  in  a  phosphorous  process  shall  present  themselves 
at  the  appointed  times  for  examination  by  the  certifying  surgeon  and  appointed 
dentist,  as  provided  in  rules  5,  6,  and  8. 

19.  Every  person  employed  in  a  phosphorous  process  and  suffering  from 
toothache  or  swelling  of  the  jaw,  or  having  had  a  tooth  extracted  or  having 
undergone  any  other  operation  involving  exposure  of  the  jaw,  shall  at  once 
inform  the  occupier,  and  shall  not  resume  employment  in  a  phosphorous  process 
without  a  certificate  of  fitness  from  the  appointed  dentist,  as  provided  in  rule  6. 

No  person  after  suspension  by  the  appointed  dentist,  or  after  reference  to  the 
certifying  surgeon,  shall  resume  empyolment  in  a  phosphorous  process  with- 
out a  certificate  of  fitness,  as  provided  in  rule  6. 

20.  Every  person  employed  in  a  phosphorous  process  for  whom  the  occupier 
is  required  by  rule  9  to  provide  overalls  shall  wear  while  at  work  the  overalls 
so  provided. 

21.  Every  person  employed  in  a  phosphorous  process  shall,  before  partaking 
of  meals  or  leaving  the  premises,  deposit  the  overalls  in  the  place  appointed  by 
the  occupier  for  the  purpose,  and  shall  thoroughly  wash  in  the  lavatory. 

22.  No  person  shall  prepare  or  partake  of  food  or  drink  in  any  room  in  which 
a  phosphorous  process  is  carried  on,  or  bring  any  food  or  drink  into  such  room. 

23.  No  person  shall  in  any  way  interfere,  without  the  knowledge  and  concur- 
rence of  the  occupier  or  manager,  with  the  means  and  appliances  provided  for 
the  removal  of  dust  and  fumes. 

24.  Foremen  and  forewomen  shall  report  to  the  manager  any  instance  coming 
under  their  notice  of  a  worker  neglecting  to  observe  these  rules. 

Akthue  Whitelegge, 
Chief  Inspector  of  Factories, 
April,  1900. 

Note. — These  rules  must  be  kept  posted  up  in  conspicuous  places  in  the  fac- 
tory to  which  they  apply,  where  they  may  be  conveniently  read  by  the  person 
employed.  Any  person  who  is  bound  to  observe  these  rules  and  fails  to  do  so 
or  acts  in  contravention  of  them  is  liable  to  a  penalty;  and  in  such  cases  the 
occupier  also  is  liable  to  a  penalty  unless  he  proves  that  he  has  taken  all  rea- 
sonable means  by  publishing  and,  to  the  best  of  his  power,  enforcing  the  rules  to 
prevent  the  contravention  or  noncompliance. 

Felt  Hats. 

Whereas  the  manufacturer  of  felt  hats  with  the  aid  of  Inflammable  solvent 
has  been  certified  in  pursuance  of  section  79  of  the  factory  and  workshop  act, 
1901,  to  be  dangerous,  I  hereby,  in  pursuance  of  the  power  conferred  on  me  by 
that  act,  make  the  following  regulations,  and  direct  that  they  shall  apply  to  all 
factories  and  workshops  in  which  any  inflammable  solvent  is  used  in  the  manu- 
facture of  felt  hats: 

1.  Every  proofing  room  and  every  stove  or  drying  room  in  which  an  inflam- 
mable solvent  is  evaporated  shall  be  thoroughly  ventilated  to  the  satisfaction  of 
the  inspector  for  the  district,  so  as  to  carry  off  as  far  as  possible  the  inflamma- 
ble vapor. 

2.  The  number  of  wet  spirit-proofed  hat  bodies  allowed  to  be  in  a  proofing 
room  at  any  one  time  shall  not  exceed  the  proportion  of  one  hat  for  each  15 
cubic  feet  of  air  space;  and  in  no  stove,  while  the  first  drying  of  any  spirit- 
proofed  hats  is  being  carried  on,  shall  the  number  of  hat  bodies  of  any  kind 
exceed  a  proportion  of  one  hat  for  each  12  cubic  feet  of  air  space. 

A  notice  stating  the  dimensions  of  each  such  room  or  stove  in  cubic  feet  and 
the  number  of  spirit-proofed  hats  allowed  to  be  therein  at  any  one  time  shall  be 
kept  constantly  affixed  in  a  conspicuous  position. 

3.  Spirit-proofed  hats  shall  be  opened  out  singly  and  exposed  for  one  hour 
before  being  placed  in  the  stove.  This  requirement  shall  not  apply  in  the  case 
of  a  stove  which  contains  no  tire  or  artificial  light  capable  of  igniting  inflamma- 
ble vapor,  and  which  is  so  constructed  and  arranged  as,  in  the  opinion  of  the 
inspector  for  the  district,  to  present  no  risk  of  such  ignition  from  external  fire 
or  light. 


356  KEPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

4.  The  above  rules,  in  so  far  as  they  affect  drying  stoves,  shall  not  apply  to 
the  process  of  drying  hat  bodies  where  the  solvent  is  recovered  in  a  closed  oven 
or  chamber  fitted  with  safe  and  suitable  apparatus  for  the  condensation  of  the 
solvent. 

5.  No  person  shall  smoke  in  any  room  or  place  in  which  inflammable  solvent 
is  exposed  to  the  air. 

These  regulations  shall  come  into  force  on  the  1st  day  of  October,  1902. 

A.  Akers-Douqlas, 
One  of  His  Majesty's  Principal  Secretaries  of  State. 
Whitehall,  August  12,  1902, 

Sfecial  Rules  foe  the  Handling  of  Dsy  and  Dbysalted  Hides  and  Skins 
Imported  feom  China  ob  feom  the  West  Coast  of  India. 

[Form  486 — February,  1906.] 

DUTIES   OF  OCCUPIEBS. 

1.  Proper  provision  to  the  reasonable  satisfaction  of  the  inspector  in  charge  of 
the  district  shall  be  made  for  the  keeping  of  the  workmen's  food  and  clothing 
outside  any  room  or  shed  in  which  any  of  the  above-described  hides  or  skins  are 
unpacked,  sorted,  packed,  or  stored. 

2.  Proper  and  sufficient  appliances  for  washing,  comprising  soap,  basins,  with 
water  laid  on  nailbrushes,  and  towels  shall  be  provided  and  maintained  for  the 
use  of  the  workmen,  to  the  reasonable  satisfaction  of  the  inspector  in  charge  of 
the  district. 

3.  Sticking  plaster  and  other  requisites  for  treating  scratches  and  slight 
wounds  shall  be  kept  at  hand,  available  for  the  use  of  the  persons  employed. 

4.  A  copy  of  the  appended  notes  shall  be  kept  affixed  with  the  rules. 

DUTIES  OF  PEESONS  EMPLOYED. 

6.  No  workman  shall  keep  any  food,  or  any  article  of  clothing  other  than 
those  he  is  wearing,  in  any  room  or  shed  in  which  any  of  the  above-described 
hides  or  skins  are  handled. 

He  shall  not  take  any  food  in  any  such  room  or  shed. 

6.  Every  workman  having  any  open  cut  or  scratch  or  raw  surface,  however 
trifling,  upon  his  face,  head,  neck,  arm,  or  hand  shall  immediately  report  the 
fact  to  the  foreman,  and  shall  not  work  on  the  premises  until  the  wound  Is 
healed  or  is  completely  covered  by  a  proper  dressing  after  being  thoroughly 
washed. 

Aethue  Whitelegge, 
Chief  Inspector  of  Factories. 
Chas.  T.  Ritchie, 
One  of  His  Majesty's  Principal  Secretaries  of  State, 
August,  1901. 

Note  1. — These  rules  must  be  kept  posted  up  in  conspicuous  places  in  the  fac- 
tory to  which  they  apply,  where  they  may  be  conveniently  read  by  the  persons 
employed.  Any  person  who  is  bound  to  observe  these  rules  and  fails  to  do  so,  or 
acts  in  contravention  of  them,  is  liable  to  a  penalty ;  and  in  such  cases  the  occu- 
pier also  is  liable  to  a  penalty  unless  he  proves  that  he  has  taken  all  reasonable 
means  by  publishing  and,  to  the  best  of  his  power,  enforcing  the  rules  to  prevent 
the  contravention  or  noncompliance. 

Note  2. — ^The  danger  against  which  these  rules  are  directed  is  that  of  an- 
thrax— a  fatal  disease  affecting  certain  animals,  which  may  be  conveyed  from 
them  to  man  by  the  handling  of  hides  of  animals  which  have  died  of  the  disease. 
The  germs  of  the  disease  (anthrax  sores)  are  found  in  the  dust  and  in  the  sub- 
stance of  the  hide,  and  may  remain  active  for  years.  In  this  country  anthrax  is 
rare,  and  precautions  are  taken  to  prevent  infected  hides  from  coming  into  the 
market,  consequently  there  is  little  danger  in  handling  the  hides  of  animals 
slaughtered  in  the  United  Kingdom;  but  in  Russia,  China,  and  the  East  Indies 
and  in  many  other  parts  of  the  world  the  disease  is  common,  and  infected  hides 
^which  do  not  differ  from  others  In  appearance)  are  often  shipped  to  British 
ports.  IToiuo.  in  It.'nulliiic:  fdipiLrii  dry  hides  the  above  rules  should  be  carefully 
obsorvcd.  wet  s;ilU'(l  hides  are  rrcc  from  dust  and  less  risk  is  incurred  in  han- 
dling them. 


EEPOETS   OP   THE  PRESIDENT'S  HOMES  COMMISSION.  357 

The  disease  Is  communicated  to  man  sometimes  by  breathing  or  swallowing 
the  dust  from  an  infected  hide,  but  much  more  usually  by  the  poison  lodging  in 
some  point  where  the  sh:in  is  broken — such  as  a  fresh  scratch  or  cut  or  a 
scratched  pimple,  or  even  chapped  hands.  This  happens  most  readily  on  the 
uncovered  parts  of  the  body,  the  hand,  arm,  face,  and  most  frequently  of  all  on 
the  neck — owing  either  to  an  infected  hide  rubbing  against  the  bare  skin,  or  to 
dust  from  such  hide  alighting  on  the  raw  surface.  But  a  raw  surface  covered 
by  clothing  is  not  free  from  risk,  for  dust  lodging  upon  the  clothes  may  sooner  or 
later  work  its  way  to  the  skin  beneath.  Infection  may  also  be  brought  about  by 
rubbing  or  scratching  a  pimple  with  hand  or  nail  carrying  the  anthrax  poison. 

The  first  symptoms  of  anthrax  is  usually  a  small  inflamed  swelling  like  a 
pimple  or  boil,  often  quite  painless,  which  extends  and  in  a  few  days  becomes 
black  at  the  center  and  surrounded  by  other  "  pimples."  The  poison  is  now 
liable  to  be  absorbed  into  the  system  and  will  cause  risk  of  life,  which  can  be 
avoided  only  by  prompt  and,  effective  medical  treatment  in  the  early  stage 
while  the  poison  is  still  confined  to  the  pimple.  Hence  it  is  of  the  utmost  im- 
portance that  a  doctor  should  at  once  be  consulted  if  there  is  any  suspicion  of 
infection. 

Note. — Suitable  overalls,  protecting  the  neck  and  arms,  as  well  as  ordinary 
clothing,  add  materially  to  the  safety  of  the  workmen,  and  should  be  provided 
and  worn,  where  practicable,  if  dangerous  hides  are  handled.  They  should  be 
discarded  on  cessation  of  work.  Similarly,  for  the  protection  of  the  hands, 
gloves  should  be  provided  and  worn  where  the  character  of  the  work  permits. 

Wool  and  Haie  Sorting. 

Whereas,  the  processes  of  sorting,  willying,  washing,  and  combing  and  card- 
ing wool,  goat  hair,  and  camel  hair  and  processes  incidental  thereto  have  been 
certified,  in  pursuance  of  section  79  of  the  factory  and  workshop  act,  1901,  to 
be  dangerous : 

I  hereby,  in  pursuance  of  the  powers  conferred  on  me  by  that  act,  make  the 
following  regulations,  and  direct  that  they  shall  apply  to  all  factories  and  work- 
shops in  which  the  said  processes  are  carried  on  and  in  which  the  materials 
named  in  the  schedules  are  used. 

It  shall  be  the  duty  of  the  occupier  to  comply  with  regulations  1  to  16.  It 
shall  be  the  duty  of  all  persons  employed  to  comply  with  regulations  17  to  23. 

These  regulations  shall  come  into  force  on  the  1st  of  January,  1906,  except 
that  regulations  2  and  8  shall  not  come  into  force  until  the  1st  of  April,  1906. 

DEFINITION. 

For  the  purpose  of  regulations  2,  3,  and  18,  opening  of  wool  or  hair  means 
the  opening  of  the  fleece,  including  the  untying  or  cutting  of  the  knots,  or,  if 
the  material  is  not  in  fleece,  the  opening  out  for  looking  over  or  classing 
purposes. 

DUTIES    OF   OCCUPIEBS. 

1.  No  bale  of  wool  or  hair  of  the  kinds  named  in  the  schedules  shall  be  opened 
for  the  purpose  of  being  sorted  or  manufactured,  except  by  men  skilled  in  judg- 
ing the  condition  of  the  material. 

No  bale  of  wool  or  hair  of  the  kinds  named  in  Schedule  A  shall  be  opened 
except  after  thorough  steeping  in  water. 

2.  No  wool  or  hair  of  the  kinds  named  in  Schedule  B  shall  be  opened  except 
(a)  after  steeping  in  water,  or  (6)  over  an  efficient  opening  screen,  with  me- 
chanical exhaust  draft,  in  a  room  set  apart  for  the  purpose,  in  which  no  other 
work  than  opening  is  carried  on. 

For  the  purpose  of  this  regulation,  no  opening  screen  shall  be  deemed  to  be 
efficient  unless  it  complies  with  the  following  conditions : 

(a)  The  area  of  the  screen  shall  in  the  case  of  existing  screens  be  not  less 
than  11  square  feet,  and  in  the  case  of  screens  hereafter  erected  be  not  less 
than  12  square  feet,  nor  shall  its  length  or  breadth  be  less  than  Si  feet. 

(6)  At  no  point  of  the  screen  within  18  inches  from  the  center  shall  the 
velocity  of  the  exhaust  draft  be  less  than  100  linear  feet  per  minute. 

3.  All  damaged  wool  or  hair  or  fallen  fleeces  or  skin  wool  or  hair,  if  of  the 
kinds  named  in  the  schedules,  shall  when  opened  be  damped  with  a  disinfectant 
and  washed  without  being  willowed. 


358  REPORTS   OF   THE   PRESIDENT'S   HOMES^ COMMISSION. 

4.  No  wool  or  hair  of  the  kinds  named  in  schedules  B  or  C  shall  be  sorted 
except  over  an  efficient  sorting  board,  with  mechanical  exhaust  draft,  and  in  a 
room  set  ai)art  for  the  purpose,  in  which  no  work  is  carried  on  other  than  sort- 
ing and  the  packing  of  the  wool  or  hair  therein. 

No  wool  or  hair  of  the  kinds  numbered  (1)  and  (2)  in  Schedule  A  shall  be 
sorted  except  in  the  damp  state  and  after  being  washed. 

No  damaged  wool  or  hair  of  the  kinds  named  in  schedules  shall  be  sorted 
except  after  being  washed. 

For  the  purix)se  of  this  regulation,  no  sorting  board  shall  be  deemed  to  be 
efficient  unless  it  complies  with  the  following  conditions : 

The  sorting  board  shall  comprise  a  screen  of  open  wirework,  and  beneath  it 
at  all  parts  a  clear  space  not  less  than  3  inches  in  depth.  Below  the  center  of 
the  screen  there  shall  be  a  funnel,  measuring  not  less  than  10  inches  across  the 
top,  leading  to  an  extraction  shaft,  and  the  arrangements  shall  be  such  that  all 
dust  falling  through  the  screen  and  not  carried  away  by  the  exhaust  can  be 
swept  directly  into  the  funnel.  The  draft  shall  be  maintained  in  constant  effi- 
ciency whilst  the  sorters  are  at  work,  and  shall  be  such  that  not  less  than  75 
cubic  feet  of  air  per  minute  are  drawn  by  the  fan  from  beneath  each  sorting 
board. 

5.  No  wool  or  hair  of  the  kinds  named  in  the  schedules  shall  be  willowed 
except  in  an  efficient  willowing  machine,  in  a  room  set  apart  for  the  purpose, 
in  which  no  work  other  than  willowing  is  carried  on. 

For  the  purpose  of  this  regulation  no  willowing  machine  shall  be  deemed  to 
be  efficient  unless  it  is  provided  with  mechanical  exhaust  draft  so  arranged  as 
to  draw  the  dust  away  from  the  workmen  and  prevent  it  from  entering  the  air 
of  the  room. 

6.  No  bale  of  wool  or  hair  shall  be  stored  in  a  sorting  room;  nor  any  wool 
or  hair  except  in  a  space  effectually  screened  off  from  the  sorting  room. 

No  wool  or  hair  shall  be  stored  in  a  willowing  room. 

7.  In  each  sorting  room,  and  exclusive  of  any  portion  screened  off,  there  shall 
be  allowed  an  air  space  of  at  least  1,000  cubic  feet  for  each  person  employed 
therein. 

8.  In  each  room  in  which  sorting,  willowing,  or  combing  is  carried  on  suitable 
inlets  from  the  open  air,  or  other  suitable  source,  shall  be  provided  and  arranged 
In  such  a  way  that  no  person  employed  shall  be  exposed  to  a  direct  draft  from 
any  air  inlet  or  to  any  draft  at  a  temperature  of  less  than  50°  F. 

The  temperature  of  the  room  shall  not  during  working  hours  fall  below 
50°  F. 

9.  All  bags  in  which  wool  or  hair  of  the  kinds  named  in  the  schedules  has 
been  imported  shall  be  picked  clean  and  not  brushed. 

10.  All  pieces  of  skin,  scab,  and  clippings  or  shearings  shall  be  removed  daily 
from  the  sorting  room,  and  shall  be  disinfected  or  destroyed. 

11.  The  dust  carried  by  the  exhaust  draft  from  opening  screens,  sorting 
boards,  willowing  or  other  dust-extracting  machines  and  shafts  shall  be  dis- 
charged into  properly  constructed  receptacles  and  not  into  the  open  air. 

Each  extracting  shaft  and  the  space  beneath  the  sorting  boards  and  opening 
screens  shall  be  cleaned  out  at  least  once  In  every  week. 

The  dust  collected  as  above,  together  with  the  sweepings  from  the  opening, 
sorting,  and  willowing  rooms,  shall  be  removed  at  least  twice  a  week  and 
burned. 

The  occupier  shall  provide  and  maintain  suitable  overalls  and  respirators 
to  be  worn  by  the  persons  engaged  in  collecting  and  removing  the  dust. 

Such  overalls  shall  not  be  taken  out  of  the  works  or  warehouse,  either  for 
washing,  repairs,  or  any  other  purpose,  unless  they  have  been  steeped  overnight 
In  boiling  water  or  a  disinfectant. 

12.  The  floor  of  every  room  in  which  opening,  sorting,  or  willowing  is  carried 
on  shall  be  thoroughly  sprinkled  daily  with  a  disinfectant  solution  after  work 
has  ceased  for  the  day,  and  shall  be  swept  immediately  after  sprinkling. 

13.  The  walls  and  ceilings  of  every  room  in  which  opening,  sorting,  or  willow- 
ing is  carried  on  shall  be  limewashed  at  least  once  a  year,  and  cleansed  at  least 
once  within  every  six  months,  to  date  from  the  time  when  they  were  last 
cleaosed. 

14.  The  following  requirements  shall  apply  to  every  room  in  which  unwashed 
wool  or  hair  of  the  kinds  named  in  the  schedules,  after  being  opened  for  sort- 
ing, manufacturing,  or  washing  purposes,  is  handled  or  stored. 

(a)  Sufficient  and  suitable  washing  accommodation  shall  be  provided  outside 
tli«  rooms  and  maintained  for  the  use  of  aU  persons  employed  in  such  room*. 


REPORTS    OP   THE   PRESIDENT'S   HOMES   COMMISSION.  S59 

The  washing  conveniences  shall  comprise  soap,  nailbrushes,  towels,  and  at 
least  one  basin  for  every  five  persons  employed  as  above,  each  basin  being 
fitted  with  a  waste  pipe  and  having  a  constant  supply  of  water  laid  on. 

(6)  Suitable  places  shall  be  provided  outside  the  rooms  in  which  persons 
employed  in  such  rooms  can  deposit  food  and  clothing  put  off  during  working 
hours. 

(c)  No  person  shall  be  allowed  to  prepare  or  partake  of  food  in  any  such 
room. 

Suitable  and  sufficient  meal  room  accommodation  shall  be  provided  for 
workers  employed  in  such  rooms. 

(d)  No  person  having  any  open  cut  or  sore  shall  be  employed  in  any  such 
room. 

The  requirements  in  paragraph  (c)  shall  apply  also  to  every  room  in  which 
any  wool  or  hair  of  the  kinds  named  in  the  schedules  is  carded  or  stored. 

15.  Requisites  for  treating  scratches  and  slight  wounds  shall  be  kept  at  hand. 

16.  The  occupier  shall  allow  any  H.  M.  inspectors  of  factories  to  take  at  any 
time,  for  the  purpose  of  examination,  sufficient  samples  of  any  wool  or  hair 
used  on  the  premises. 

DUTIES   OF  PEESONS   EMPLOYED. 

17.  No  bale  of  wool  or  hair  of  the  kinds  named  In  the  schedules  shall  be 
opened  otherwise  than  as  permitted  by  paragraph  1  or  regulation  1,  and  no  bale 
of  wool  or  hair  of  the  kinds  named  in  Schedule  A  shall  be  opened  except  after 
thorough  steeping  in  water. 

If  on  opening  a  bale  any  damaged  wool  or  hair  of  the  kinds  named  in  the 
schedules  is  discovered,  the  person  opening  the  bale  shall  immediately  report 
the  discovery  to  the  foreman. 

18.  No  wool  or  hair  of  the  kinds  named  in  Schedule  B  shall  be  opened  other- 
wise than  as  permitted  by  regulation  2. 

19.  No  wool  or  hair  of  the  kinds  named  in  the  schedules  shall  be  sorted  other- 
wise than  as  permitted  by  regulation  4. 

20.  No  wool  or  hair  of  the  kinds  named  in  the  schedules  shall  be  willowed 
except  as  permitted  by  regulation  5. 

21.  Every  person  employed  in  a  room  in  which  unwashed  wool  or  hair  of  the 
kinds  named  in  the  schedules  is  stored  or  handled  shall  observe  the  following 
requirements : 

(a)  He  shall  wash  his  hands  before  partaking  of  food,  or  leaving  the  premises. 

( & )  He  shall  not  deposit  in  any  such  room  any  article  of  clothing  put  off  dur- 
ing working  hours. 

He  shall  wear  suitable  overalls  while  at  work,  and  shall  remove  them  before 
partaking  of  food  or  leaving  the  premises. 

(c)  If  he  has  any  open  cut  or  sore,  he  shall  report  the  fact  at  once  to  the 
foreman,  and  shall  not  work  in  such  a  room. 

No  person  employed  in  any  such  room  or  in  any  room  in  which  wool  or  hair 
of  the  kinds  named  in  the  schedule  is  either  carded  or  stored  shall  prepare  or 
partake  of  any  food  therein,  or  bring  any  food  therein. 

22.  Persons  engaged  in  collecting  or  removing  dust  shall  wear  the  overalls  as 
required  by  regulation  11. 

Such  overalls  shall  not  be  taken  out  of  the  works  or  warehouse  either  for 
washing,  repairs,  or  any  other  purpose,  unless  they  have  been  steeped  overnight 
in  boiling  water  or  a  disinfectant. 

23.  If  any  fan,  or  any  other  appliance  for  the  carrying  out  of  these  regu- 
lations, is  out  of  order,  any  workman  becoming  aware  of  the  defect  shall  imme- 
diately report  the  fact  to  the  foreman. 

H.  J.  Gladstone, 
One  of  Her  Majesty's  Principal  Secretaries  of  State. 
Home  Office,  Whitehall,  12th  December,  1903. 

Schedule  A. 

(Wool  or  hair  required  to  be  opened  either  after  steeping  or  over  an  efficient 
opening  screen.) 

1.  Van  mohair. 

2.  Persian  locks. 

3.  Persian  or  so-called  Persian  (including  Karadi  and  Bagdad)  if  not  snb- 
jected  to  the  process  of  sorting  or  willowing. 


360  EEPOETS  OF   THE  PRESIDENT'S  HOMES  COMMISSION, 

Schedule  B, 

(Wool  or  hair  required  to  be  opened  either  after  steeping  or  oyer  an  efficient 
opening  screen.) 

Alpaca. 

Pelitan. 

East  Indian  cashmerew 

Russian  camel  hair.  , 

Pekin  camel  hair. 

Persian  or  so-called  Persian  (including  Karadl  and  Bagdad)  if  subjected  to 
the  process  of  sorting  or  willowing. 

Schedule  0, 

(Wool  or  hair  not  needing  to  be  opened  over  an  opening  screen,  but  required 
to  be  sorted  over  a  board  provided  with  downward  draft.) 

All  mohair  other  than  van  mohair. 

Note. — The  danger  against  which  these  regulations  are  directed  is  that  of 
anthrax — a  fatal  disease  affecting  certain  animals,  which  my  be  conveyed  from 
them  to  man  by  the  handling  of  wools  or  hairs  from  animals  which  have  died 
of  the  disease.  The  germs  of  the  disease  (anthrax  spores)  are  found  in  the  dust 
attaching  to  the  wool,  or  in  the  excrement,  and  in  the  substance  of  the  pieces 
of  skin,  and  may  remain  active  for  years.  In  this  country  and  Australia  anthrax 
is  rare,  consequently  there  is  little  danger  in  handling  wools  from  the  sheep  of 
these  two  countries,  but  in  China,  Persia,  Turkey,  Russia,  the  East  Indies,  and 
in  many  other  parts  of  the  world,  the  disease  is  common,  and  infected  fleeces  or 
locks  (which  may  not  differ  from  others  in  appearance)  are  often  shipped  to 
Great  Britain.  Hence,  in  handling  foreign  dry  wools  and  hair,  the  above  regu- 
lations should  be  carefully  observed.  Greasy  wools  are  comparatively  free 
from  dust  and  therefore  little  risk  is  incurred  in  handling  them.  The  disease  is 
communicated  to  man  sometimes  by  breathing  or  swallowing  the  dust  from  these 
wools  or  hair,  and  sometimes  by  the  poison  lodging  in  some  point  where  the 
skin  is  broken,  such  as  a  fresh  scratch  or  cut,  or  a  scratched  pimple,  or  even 
chapped  hands.  This  happens  more  readily  on  the  uncovered  parts  of  the  body, 
the  hand,  arm,  face,  and  most  frequently  of  all,  on  the  neck,  owing  either  to 
infected  wool  rubbing  against  the  bare  skin,  or  to  dust  from  such  wool  alight- 
ing on  the  raw  surface.  But  a  raw  surface  covered  by  clothing  is  not  free 
from  risk,  for  the  dust  lodging  upon  the  clothes  may  sooner  or  later  work  its 
way  to  the  skin  beneath.  Infection  may  also  be  brought  about  by  rubbing  or 
scratching  a  pimple  with  hand  or  nail  carrying  the  anthrax  poison.  Use  of  the 
nailbrush,  and  frequent  washing  and  bathing  of  the  whole  body,  especially  of 
the  arms,  neck,  and  head,  will  lessen  the  chance  of  contracting  anthrax. 

The  first  symptom  of  anthrax  is  usually  a  small  inflamed  swelling  like  a 
pimple  or  boil — often  quite  painless — which  extends,  and  in  a  few  days  becomes 
black  at  the  center,  and  surrounded  by  other  "pimples."  The  poison  is  now 
liable  to  be  absorbed  into  the  system,  and  will  cause  risk  of  life,  which  can  be 
avoided  only  by  prompt  and  effective  medical  treatment  in  the  early  stage,  while 
the  poison  is  still  confined  to  the  pimple.  Hence,  it  is  of  the  utmost  importance 
that  a  doctor  should  be  at  once  consulted  if  there  is  any  suspicion  of  infection. 

Flax  and  Tow  SriNNiifQ  and  Weaving. 

Whereas  the  processes  of  spinning  and  weaving  flax  and  tow  and  the  proc- 
esses incidental  thereto  have  been  certified  in  pursuance  of  section  79  of  the 
factory  and  workshop  act,  1901,  to  be  dangerous : 

I  hereby,,  in  pursuance  of  the  powers  conferred  on  me  by  that  act,  make  the 
following  regulations,  and  direct  that  they  shall  apply  to  all  factories  in  which 
the  processes  named  above  are  carried  on,  and  to  all  workshops  in  which  the 
processes  of  roughing,  sorting,  and  hand-hackling  of  flax  or  tow  are  carried  on. 

These  r^ulations  shall  come  into  force  on  the  1st  day  of  February,  1907. 

Provided  that  in  case  of  all  rooms  in  which  roughing  or  hand-hackling  is 
now  carried  on,  and  in  which  there  is  respectively  (a)  no  system  of  local 
mechanical  exhaust  ventilation,  or  (&)  no  artificial  means  of  regulating  the 
temperature,  Regulations  2  and  3,  respectively,  shall  not  come  into  force  until 
the  1st  day  of  February,  1908. 


REPORTS  OP  THE  PRESIDENT'S  HOMES  COMMISSION.  361 

DEPINmONS. 

In  these  regulations — 

"  Degrees  "  means  degrees  on  the  Fahrenheit  scale. 

"  Roughing,  sorting,  hand-hackling,  machine-hacliling,  carding,  and  preparing  " 
mean  those  processes  in  the  manufacture  of  flax  or  tow. 

It  shall  be  the  duty  of  the  occupier  to  observe  Part  I  of  these  regulations. 

It  shall  be  the  duty  of  all  persons  employed  to  observe  Part  II  of  these 
regulations. 

PART   I. — ^DUTIES   OF   OCCTJPIEBS. 

1.  In  every  room  in  which  persons  are  employed  the  arrangements  shall  be 
such  that  during  working  hours  the  proportion  of  carbonic  acid  in  the  air  of  the 
room  shall  not  exceed  20  volumes  per  10,000  volumes  of  air  at  any  time  when 
gas  or  oil  is  used  for  lighting  (or  within  one  hour  thereafter)  or  12  volumes 
per  10,000  when  electric  light  is  used  (or  within  one  hour  thereafter)  or  9 
volumes  per  10,000  at  any  other  time. 

Provided  that  it  shall  be  a  sufficient  compliance  with  this  regulation  if  the 
proportion  of  carbonic  acid  in  the  air  of  the  room  does  not  exceed  that  of  the 
open  air  outside  by  more  than  5  volumes  per  10,000  volumes  of  air. 

2.  In  every  room  in  which  roughing,  sorting,  or  hand-hackling  is  carried  on, 
and  in  every  room  in  which  machine-hackling,  carding,  or  preparing  is  carried 
on,  and  in  which  dust  is  generated  and  inhaled  to  an  extent  likely  to  cause 
injury  to  the  health  of  the  workers,  efficient  exhaust  and  inlet  ventilation  shall 
be  provided  to  secure  that  the  dust  is  drawn  away  from  the  workers  at,  or  as 
near  as  reasonably  possible  to,  the  point  at  which  it  is  generated. 

For  the  purposes  of  this  regulation  the  exhaust  ventilation  in  the  case  of 
hand-hackling,  roughing,  or  sorting  shall  not  be  deemed  to  be  efficient  if  the 
exhaust  opening  at  the  back  of  the  hackling  pins  measures  less  than  4  inches 
across  in  any  direction,  or  has  a  sectional  area  of  less  than  50  square  inches, 
or  if  the  linear  velocity  of  the  draft  passing  through  it  is  less  than  400  feet 
per  minute  at  any  point  within  a  sectional  area  of  50  square  inches. 

3.  In  every  room  in  which  hand-hackling,  roughing,  sorting,  machine-hack- 
ling, carding,  or  preparing  is  carried  on,  an  accurate  thermometer  shall  be  kept 
affixed;  and  the  arrangements  shall  be  such  that  the  temperature  of  the  room 
shall  not  at  any  time  during  working  hours  where  hand-hackling,  roughing,  or 
machine-hackling  is  carried  on  fall  below  50°,  or  where  sorting,  carding,  or 
preparing  is  carried  on  below  55° ;  and  that  no  person  employed  shall  be  ex- 
posed to  a  direct  draft  from  any  air  inlet,  or  to  any  draft  at  a  temperament 
of  less  than  50*. 

Provided  that  it  shall  be  a  sufficient  compliance  with  this  regulation  if  the 
heating  apparatus  be  put  into  operation  at  the  commencement  of  work,  and  if 
the  required  temperature  be  maintained  after  the  expiration  of  one  hour  from 
the  commencement  of  work. 

4.  In  every  room  in  which  wet  spinning  is  carried  on,  or  in  which  artificial 
humidity  of  air  is  produced  in  aid  of  manufacture,  a  set  of  standardized  wet 
and  dry  bulb  thermometers  shall  be  kept  affixed  in  the  center  of  the  room  or 
in  such  other  position  as  may  be  directed  by  the  inspector  of  the  district  by 
notice  in  writing,  and  shall  be  maintained  in  correct  working  order. 

Each  of  the  above  thermometers  shall  be  read  between  10  and  11  a.  m.  on 
every  day  that  any  person  is  employed  in  the  room,  and  again  between  3  and 
4  p.  m.  on  every  day  that  any  person  is  employed  in  the  room  after  1  p.  m., 
and  each  reading  shall  be  at  once  entered  on  the  prescribed  form. 

The  form  shall  be  hung  up  near  the  thermometers  to  which  it  relates,  and 
shall  be  forwarded,  duly  filled  in,  at  the  end  of  each  calendar  month  to  the 
inspector  of  the  district.  Provided,  that  this  part  of  this  regulation  shall  not 
apply  to  any  room  in  which  the  difference  of  reading  between  the  wet  and  dry 
bulb  thermometers  is  never  less  than  4°,  if  notice  of  intention  to  work  on  that 
system  has  been  given  in  the  prescribed  form  to  the  inspectors  for  the  district, 
and  a  copy  of  the  notice  is  kept  affixed  in  the  room  to  which  it  applies. 

5.  The  humidity  of  the  atmosphere  of  any  room  to  which  regulation  4  applies 
shall  not  at  any  time  be  such  that  the  difference  between  the  readings  of  the 
wet  and  dry  bulb  thermometers  is  less  than  2°. 

6.  No  water  shall  be  used  for  producing  humidity  of  the  air,  or  in  wet- 
spinning  troughs,  which  is  liable  to  cause  injury  to  the  health  of  the  persons 
employed  or  to  yield  effluvia ;  and  for  the  purpose  of  this  regulation  any  water 


362  EEPORTS  OF   THE  PKESIDENT^S  HOMES  COMMISSION. 

which  absorbs  from  acid  solution  of  permanganate  of  potash  in  four  hours  at 
60°  more  than  0.5  grains  of  oxygen  per  gallon  of  water  shall  be  deemed  to  be 
liable  to  cause  injury  to  the  health  of  the  persons  employed. 

7.  Efficient  means  shall  be  adopted  to  prevent  the  escape  of  steam  from  wet- 
spinning  troughs. 

8.  The  pipes  used  for  the  introduction  of  steam  into  any  room  in  which  the 
temperature  exceeds  70°,  or  for  heating  the  water  in  any  wet-spinning  trough, 
shall  so  far  as  they  are  within  the  room  and  not  covered  by  water  be  as  small 
in  diameter  and  as  limited  in  length  as  is  reasonably  practicable,  and  shall  be 
effectively  covered  with  nonconducting  material. 

9.  Efficient  splash  guards  shall  be  provided  and  maintained  on  all  wet-spin- 
ning frames  of  2i-inch  pitch  and  over,  and  on  all  other  wet-spinning  frames 
unless  waterproof  skirts  and  bibs  of  suitable  material  are  provided  by  the 
occupier  and  worn  by  the  workers. 

Provided,  that  if  the  chief  inspector  is  satisfied  with  regard  to  premises  in 
use  prior  to  30th  June,  1905,  that  the  structural  conditions  are  such  that  splash 
guards  can  not  conveniently  be  used,  he  may  suspend  the  requirements  as  to 
splash  guards.  Such  suspension  shall  only  be  allowed  by  certificate  in  writing, 
signed  by  the  chief  inspector,  and  shall  be  subject  to  such  conditions  as  may  be 
stated  in  the  certificate. 

10.  The  floor  of  every  wet-spinning  room  shall  be  kept  in  sound  condition, 
and  drained  so  as  to  prevent  retention  or  accumulation  of  water. 

11.  There  shall  be  provided  for  all  persons  employed  in  any  room  in  which 
wet  spinning  is  carried  on,  or  in  which  artificial  humidity  of  air  is  produced 
in  air  of  manufacture,  suitable  and  convenient  accommodaton  in  which  to  keep 
the  clothing  taken  off  before  starting  work,  and  in  the  case  of  building  erected 
after  30th  June,  1905,  in  which  the  difference  between  the  readings  of  the  wet 
and  dry  bulb  thermometers  is  at  any  time  less  than  4°,  such  accommodation 
shall  be  provided  in  cloak  rooms,  ventilated,  and  kept  at  a  suitable  temperature 
and  situated  in  or  near  the  workrooms  in  question. 

12.  Suitable  and  efficient  respirators  shall  be  provided  for  the  use  of  the 
persons  employed  in  machine-hackling,  preparing,  and  carding. 

PAET  II. — ^DUTIES  OF  PERSONS  EMPLOYED. 

13.  All  persons  employed  on  wet-spinning  frames  without  efficient  splash 
guards  shall  wear  the  skirts  and  bibs  provided  by  the  occupier  in  pursuance  of 
regulation  9. 

14.  No  person  shall  in  any  way  interfere,  without  the  concurrence  of  the 
occupier  or  manager,  with  the  means  and  appliances  provided  for  ventilation, 
or  for  the  removal  of  dust,  or  for  the  other  purposes  of  these  regulations. 

H.  J.  Gladstone, 
One  of  His  Majesty's  Principal  Secretaries  of  State. 
Home  Office,  Whitehall,  80th  February,  1906, 

File  Cutting  by  Hand. 

Whereas  the  process  of  file  cutting  by  hand  has  been  certified  in  pursuance 
of  section  79  of  the  factory  and  workshop  act,  1901,  to  be  dangerous : 

I  hereby,  in  pursuance  of  the  powers  conferred  on  me  by  that  act,  make  the 
following  regulations,  and  direct  that  'they  shall  apply  to  all  factories  and 
workshops  (including  tenement  factories  and  tenement  workshops)  or  parts 
thereof  in  which  the  process  of  file  cutting  by  hand  is  carried  on;  provided 
that  the  chief  inspector  of  factories  may  by  certificate  in  writing  exempt  from 
all  or  any  of  these  regulations  any  factory  or  workshop  in  which  he  is  satisfied 
that  the  beds  used  are  of  such  composition  as  not  to  entail  danger  to  the  health 
of  the  persons  employed. 

1.  The  number  of  stocks  in  any  room  shall  not  be  more  than  one  stock  for 
every  350  cubic  feet  of  air  space  in  the  room ;  and  in  calculating  air  space  for 
the  purpose  of  this  regulation  any  space  more  than  10  feet  above  the  floor  of 
the  room  slyill  not  be  reckoned. 

2.  After  the  1st  day  of  January,  1904,  the  distance  between  the  stocks  meas- 
ured from  the  center  of  one  stock  to  the  center  of  the  next  shall  not  be  less 
than  2  feet  6  inches,  and  after  the  1st  day  of  January,  1905,  the  said  distance 
Bhall  not  be  less  than  3  feet. 


REPORTS   OF   THE   PRESIDENT'S  HOMES   COMMISSION.  363 

3.  Every  room  shall  have  a  substantial  floor,  the  whole  of  which  shall  be 
covered  with  a  washable  material,  save  that  it  shall  be  optional  to  leave  a 
space  not  exceeding  6  inches  in  width  round  the  base  of  each  stock. 

The  floor  of  every  room  shall  be  kept  in  good  repair. 

4.  Efficient  inlet  and  outlet  ventilators  shall  be  provided  hi  every  room.  The 
inlet  ventilators  shall  be  so  arranged  and  placed  as  not  to  cause  a  direct  draft 
of  incoming  air  to  fall  on  the  workmen  employed  at  the  stocks. 

The  ventilators  shall  be  kept  in  good  repair  and  in  working  order. 

5.  No  person  shall  interfere  with  or  impede  the  working  of  the  ventilators. 

6.  Sufficient  and  suitable  washing  conveniences  shall  be  provided  and  main- 
tained for  the  use  of  the  file  cutters.  The  washing  conveniences  shall  be  under 
cover  and  shall  comprise  at  least  one  fixed  basin  for  every  ten  or  less  stocks. 
Every  basin  shall  be  fitted  with  a  waste  pipe  discharging  over  a  drain  or  into 
some  receptacle  of  a  capacity  at  least  equal  to  1  gallon  for  every  file  cutter 
using  the  basin.  Water  shall  be  laid  onto  every  basin  either  from  the  main  or 
from  a  tank  of  a  capacity  of  not  less  than  11  gallons  to  every  worker  supplied 
from  such  tank.  A  supply  of  clean  water  shall  be  kept  in  the  said  tank  while 
work  is  going  on  at  least  sufficient  to  enable  every  worker  supplied  from  such 
tank  to  wash. 

7.  The  walls  and  ceiling  of  every  room,  except  such  parts  as  are  painted  or 
varnished  or  made  of  glazed  brick,  shall  be  limewashed  once  in  every  six 
months  ending  the  30th  of  June  and  once  in  every  six  months  ending  the  31st  of 
December. 

8.  The  floor  and  such  parts  of  the  walls  and  ceiling  as  are  not  limewashed 
and  the  benches  shall  be  cleansed  once  a  week. 

9.  If  the  factory  or  workshop  is  situated  in  a  dwelling  house  the  work  of  file 
cutting  shall  not  be  carried  on  in  any  room  which  is  used  as  a  sleeping  place 
or  for  cooking  or  eating  meals. 

10.  Every  file  cutter  shall  when  at  work  wear  a  long  apron  reaching  from 
the  shoulders  and  neck  to  below  the  knees.  The  apron  shall  be  kept  in  a 
cleanly  state. 

11.  A  copy  of  these  regulations  and  an  abstract  of  the  provisions  of  the  fac- 
tory and  workshop  act,  1901,  shall  be  kept  affixed  in  the  factory  or  workshop 
in  a  conspicuous  place. 

12.  It  shall  be  the  duty  of  the  occupier  to  carry  out  regulations  1,  2,  3,  4,  6, 
7,  and  11;  except  that,  in  any  room  in  a  tenement  factory  or  tenement  work- 
shop which  is  let  to  more  than  one  occupier,  it  shall  be  the  duty  of  the  owner  to 
carry  out  these  regulations,  except  the  last  clause  of  regulation  6,  which  shall 
be  carried  out  by  the  occupiers. 

It  shall  be  the  duty  of  the  occupier  or  occupiers  to  carry  out  regulation  8. 
It  shall  be  the  duty  of  the  occupier  or  occupiers  and  of  every  workman  to 
observe  regulations  5,  9,  and  10. 

These  regulations  shall  come  into  force  on  the  1st  day  of  September,  1903. 

A.  Akers-Douglas, 
One  of  His  Majesty's  Principal  Secretaries  of  State, 
Home  Office,  Whitehall,  19th  Jv/ne,  190S. 

Special  Rules  for  the  Bottling  of  Aerated  Wateb. 

[Form  273— A  1-3-01.] 

DUTIES    OF    OCCUPIERS. 

1.  They  shall  provide  all  bottlers  with  face  guards,  masks,  or  veils  of  wire 
gauze. 

They  shall  provide  all  wirers,  sighters,  and  labelers  with  face  guards,  masks, 
or  veils  of  wire  gauze,  or  goggles. 

2.  They  shall  provide  all  bottlers  with  full-length  gauntlets  for  both  arms. 
They  shall  provide  all  wirers,  sighters,  and  labelers  with  gauntlets  for  both 

arms,  protecting  at  least  half  of  the  palm  and  the  space  between  the  thumb 
and  forefinger. 

3.  They  shall  cause  all  machines  for  bottling  to  be  constructed,  so  placed,  or 
so  fenced,  as  to  prevent  as  far  as  possible,  during  the  operation  of  filling  or 
corking,  a  fragment  of  a  bursting  bottle  from  striking  any  bottler,  wirer, 
sighter,  labeler,  or  washer. 


364  KEPORTS   OF   THE  PRESIDENT 's  HOMES  COMMISSION. 

DUTIES    OF    PEESONS   EMPLOYED. 

4.  All  bottlers  shall,  while  at  work,  wear  face  guards,  masks,  or  veils  of  wire 
gauze. 

All  wirers,  sighters,  and  label ers  shall,  while  at  work,  wear  on  both  arms 
gauntlets  protecting  at  least  half  of  the  palm  and  the  space  between  the  thumb 
and  forefinger;  except  labelers  when  labeling  bottles  standing  in  cases. 

Abthue  Whitelegge, 
His  Majesty's  Inspector  of  Factories. 
August,  1897. 

These  rules  are  required  to  be  posted  up  in  conspicuous  places  in  the  factory 
or  workshop  to  which  they  apply,  where  they  may  be  conveniently  read  by  the 
persons  employed  therein,  who  are  bound  to  observe  any  special  rules,  are  liable 
to  a  penalty  of  £5  ($24.33).  Occupiers  of  factories  and  workshops  and  persons 
employed  therein  who  are  bound  to  observe  any  special  rules  are  liable  to 
penalties  for  noncompliance  (factory  and  workshop  act,  1891,  sections  9 
and  11). 

The  employer  is  required  to  provide  the  articles  mentioned  in  the  rules,  and 
to  take  all  reasonable  precautions  to  the  best  of  his  power  to  enforce  their 
use,  but  the  responsibility  for  the  actual  wearing  of  them  rests  with  the  person 
employed. 

Spinning  by  Self-Acting  Mules. 

Whereas  certain  machinery  used  in  the  process  of  spinning  in  textile  fac- 
tories, and  known  as  self-acting  mules,  has  been  certified  in  pursuance  of  sec- 
tion 79  of  the  factory  and  workshop  act,  1901,  to  be  dangerous  to  life  and 
limb: 

I  hereby,  in  pursuance  of  the  powers  conferred  on  me  by  that  act,  make  the 
following  regulations,  and  direct  that  they  shall  apply  to  all  factories  or  parts 
thereof  in  which  the  process  of  spinning  by  means  of  self-acting  mules  is 
carried  on: 

1.  In  these  regulations  the  term  "minder"  means  the  person  in  charge  of  a 
self-acting  mule  for  the  time  being. 

2.  Save  as  hereinafter  provided,  it  shall  be  the  duty  of  the  occupier  of  a 
factory  to  observe  Part  I  of  these  regulations;  provided  that  it  shall  be  the 
duty  of  the  owner  (whether  or  not  he  is  one  of  the  occupiers)  of  a  tenement 
factory  to  observe  Part  I  of  these  regulations,  except  so  far  as  relates  to  such 
parts  of  the  machinery  as  are  supplied  by  the  occupier. 

It  shall  be  the  duty  of  the  persons  employed  to  observe  Part  II  of  these 
regulations,  but  it  shall  be  the  duty  of  the  occupier,  for  the  purpose  of  en- 
forcing their  observance,  to  keep  a  copy  of  the  regulations  In  legible  characters 
affixed  in  every  mule  room,  in  a  conspicuous  position,  where  they  may  be 
conveniently  read. 

PAST    I. — ^duties    of    occupiers. 

8.  After  January  1,  1906,  the  following  parts  of  every  self-acting  mule  shall 
be  securely  fenced  as  far  as  reasonably  practicable,  unless  it  can  be  shown  that 
by  their  position  or  construction  they  are  equally  safe  to  every  person  employed 
as  they  would  be  if  securely  fenced : 

(a)  Back  shaft  scrolls  and  carrier  pulleys  and  draw  band  pulleys. 

(ft)  Front  and  back  carriage  wheels. 

(c)  Faller-stops. 

id)  Quadrant  pinions. 

(e)  Back  of  headstocks,  including  rim  pulleys  and  taking-in  scrolls. 

(/)  Rim  band  tightening  pulleys,  other  than  plate  wheels,  connected  with  a 
self-acting  mule  erected  after  January  1,  1906. 

PART  n. — duties  of  persons  employed. 

4.  It  shall  be  the  duty  of  the  minder  of  every  self-acting  mule  to  take  all 
reasonable  care  to  insure: 

(o)  That  no  child  cleans  any  part  or  under  any  part  thereof  whilst  the  mule 
is  In  motion  by  the  aid  of  mechanical  power. 


EEPORTS   OF   THE  PKESIDENt's  HOMES  COMMISSION.  365 

(6)  That  no  woman,  young  person,  or  child  work  between  the  fixed  and 
traversing  parts  thereof  whilst  the  mule  is  in  motion  by  the  aid  of  mechanical 
power. 

(c)  That  no  person  is  in  the  space  between  the  fixed  and  traversing  parts 
thereof  unless  the  mule  is  stopped  on  the  outward  run. 

5,  No  self-acting  mule  shall  be  started  or  restarted  except  by  the  minder  or 
at  his  express  orders,  nor  until  he  has  ascertained  that  no  person  is  in  the  space 
betweeen  the  fixed  and  traversing  parts  thereof. 

A.  Akeks-Douglas, 
One  of  His  Majesty's  Principal  Secretaries  of  State. 

Home  Office,  Whitehall,  11th  October,  1905. 

Loading  Goods  on  Docks  and  Whabves. 

Whereas  the  processes  of  loading,  unloading,  moving,  and  handling  goods  in, 
on,  or  at  any  dock,  wharf,  or  quay,  and  the  processes  of  loading,  unloading,  and 
coaling  any  ship  in  any  dock,  harbor,  or  canal  have  been  certified  in  pursuance 
of  section  79  of  the  factory  and  workshop  act,  1901,  to  be  dangerous : 

I  hereby,  in  pursuance  of  the  powers  conferred  on  me  by  that  act  make  the 
following  regulations  for  the  protection  of  persons  employed  in  the  processes  or 
In  any  of  them,  and  direct  that  they  shall  apply  to  all  docks,  wharves,  quays, 
and  ships  as  aforesaid. 

These  regulations  shall  come  Into  force  on  the  1st  of  January,  1905,  except 
that  so  much  of  regulations  6  and  8  as  require  structural  alterations  shall  come 
into  force  on  the  1st  of  January,  1908. 

Nothing  in  Parts  II  to  VI,  inclusive,  of  these  regulations  shall  apply  to  the 
unloading  of  fish  from  a  vessel  employed  in  the  catching  of  fish. 

The  secretary  of  state  may  by  order  in  writing  exempt  from  all  or  any  of  the 
regulations  and  for  such  time  and  subject  to  such  conditions  as  he  may  prescribe 
any  docks,  wharves,  or  quays  in  respect  of  which  application  for  such  exemption 
shall  have  been  made  to  him  by  the  department  of  agriculture  and  technical 
Instruction  for  Ireland  or  by  the  congested  districts  board  for  Ireland. 

definitions. 

"Processes'*  means  the  processes  above  mentioned,  or  any  of  them. 

"  Persons  employed  "  means  a  person  employed  in  the  above  processes,  or  any 
of  them. 

"  Shallow  canal "  includes  any  of  the  following  parts  of  a  canal,  canalized 
river,  nontidal  river,  or  inland  navigation : 

(a)  Any  part  having  no  means  of  access  to  tidal  waters  except  through  a 
lock  not  exceeding  90  feet  in  length;  (&)  any  part  not  in  frequent  use  for  the 
processes;  and  (c)  any  part  at  which  the  depth  of  water  within  15  feet  of  the 
edge  does  not  ordinarily  exceed  5  feet. 

DUTIES. 

It  shall  be  the  duty  of  the  person  having  the  general  management  and  control 
of  a  dock,  wharf,  or  quay  to  comply  with  Part  I  of  these  regulations ;  provided 
that  if  any  other  person  has  the  exclusive  right  to  occupation  of  any  part  of  the 
dock,  wharf,  or  quay,  and  has  the  general  management  and  control  of  such  part 
the  duty  in  respect  of  that  part  shall  devolve  upon  that  other  person;  and 
further  provided  that  this  part  of  these  regulations  shall  not  apply  to  any 
shallow  canal. 

It  shall  be  the  duty  of  the  owner  or  officer  in  charge  of  a  ship  to  comply  with 
Part  II  of  these  regulations. 

It  shall  be  the  duty  of  the  owner  of  machinery  or  plant  used  in  the  processes, 
ahd  in  the  case  of  machinery  or  plant  carried  on  board  a  ship  not  being  a  ship 
registered  in  the  United  Kingdom  it  shall  also  be  the  duty  of  the  master  of 
such  ship,  to  comply  with  Part  III  of  these  regulations. 

It  shall  be  the  duty  of  every  person  who  by  himself,  his  agents,  or  workmen 
carries  on  the  processes,  and  of  all  agents,  workmen,  and  persons  employed  by 
him  in  the  processes,  to  comply  with  Part  IV  of  these  regulations. 

It  shall  be  the  duty  of  all  persons,  whether  owners,  occupiers,  or  persons  em- 
ployed, to  comply  with  Part  V  of  these  regulations. 

Part  VI  of  these  regulations  shall  be  complied  with  by  the  persons  on  whom 
the  duty  is  placed  in  that  part. 


366  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

PAST  I. 

1.  The  following  parts  of  every  dock,  wharf,  or  quay,  as  far  as  is  practicable, 
having  regard  to  the  traflBc  and  working,  be  securely  fenced  so  that  the  height 
of  the  fence  shall  be  in  no  place  less  than  2  feet  6  inches,  and  the  fencing  shall 
be  maintained  in  good  condition  ready  for  use. 

(a)  All  breaks,  dangerous  corners,  and  other  dangerous  parts  of  edges  of  a 
dock,  wharf,  or  quay. 

(&)  Both  sides  of  such  footways  over  bridges,  caissons,  and  dock  gates  as  are 
in  general  use  by  persons  employed,  and  each  side  of  the  entrance  at  each  end 
of  such  footway  for  a  suflacient  distance  not  exceeding  5  yards. 

2.  Provision  for  the  rescue  from  drowning  of  persons  employed  shall  be  made 
and  maintained,  and  shall  include: 

(a)  A  supply  of  life-saving  appliances,  kept  in  readiness  on  the  wharf  or 
quay,  which  shall  be  reasonably  adequate,  having  regard  to  all  the  circum- 
stances. 

3.  All  places  In  which  persons  employed  are  employed  at  night,  and  any  dan- 
gerous parts  of  the  regular  road  or  way  over  a  dock,  wharf,  or  quay,  forming 
the  approach  to  any  such  place  from  the  nearest  highway,  shall  be  efficiently 
lighted. 

Provided  that  the  towing  path  of  a  canal  or  canalized  river  shall  not  be 
deemed  to  be  "  an  approach  "  for  the  purpose  of  this  regulation. 

PAST  n. 

4.  If  a  ship  is  lying  at  a  wharf  or  quay  for  the  purpose  of  loading  or  unload- 
ing or  coaling  there  shall  be  means  of  access  for  the  use  of  persons  employed 
at  such  times  as  they  have  to  pass  from  the  ship  to  the  shore  or  from  the  shore 
to  the  ship,  as  follows: 

(a)  Where  a  gangway  is  reasonably  practicable  a  gangway  not  less  than  22 
inches  wide,  properly  secured,  and  fenced  throughout  on  each  side  to  a  clear 
height  of  2  feet  9  inches  by  means  of  upper  and  lower  rails,  taut  ropes,  or  chains, 
or  by  other  equally  safe  means. 

(b)  In  other  cases  a  secure  ladder  of  adequate  length. 

Provided  that  nothing  in  this  regulation  shall  be  held  to  apply  to  cargo  stages 
or  cargo  gangways,  if  other  proper  means  of  access  is  provided  in  conformity 
with  these  regulations. 

Provided  that  as  regards  any  sailing  vessel  not  exceeding  250  tons  net  reg- 
istered tonnage  and  any  steam  vessel  not  exceeding  150  tons  gross  registered 
tonnage  this  regulation  shall  not  apply  if  and  while  the  conditions  are  such 
that  it  is  possible,  without  undue  risk,  to  pass  to  and  from  the  ship  without  the 
aid  of  any  special  appliances. 

5.  If  a  ship  is  alongside  any  other  ship,  vessel,  or  boat,  and  persons  employed 
have  to  pass  from  one  to  the  other,  safe  means  of  access  shall  be  provided  for 
their  use,  unless  the  conditions  are  such  that  it  is  impossible  to  pass  from  one  to 
the  other  without  undue  risk  without  the  aid  of  any  special  appliance. 

If  one  of  such  ships,  vessels,  or  boats  is  a  sailing  barge,  flat,  keel,  lighter,  or 
other  similar  vessel  of  relatively  low  freeboard,  the  means  of  access  shall  be 
provided  by  the  ship  which  has  the  hiirher  freeboard. 

6.  If  the  depth  from  the  top  of  the  coamings  to  the  bottom  of  the  hold  exceeds 
6  feet,  there  shall  be  maintained  safe  means  of  access  by  ladder  or  steps  from 
the  deck  to  the  hold  in  which  work  is  being  carried  on,  with  secure  handhold 
and  foothold  continued  to  the  top  of  the  coamings. 

In  particular  such  access  shall  not  be  deemed  to  be  safe : 

(a)  Unless  the  ladders  between  the  lower  decks  are  in  the  same  line  as  the 
ladder  from  the  main  deck,  if  the  same  is  practicable  having  regard  to  the 
position  of  the  lower  hatchway  or  hatchways. 

(b)  Unless  the  cargo  is  stowed  sufficiently  far  from  the  ladder  to  leave  at 
each  rung  of  the  ladder  sufficient  room  for  a  man's  feet. 

(c)  If  there  is  not  room  to  pass  between  a  winch  and  the  coamings  at  the 
place  where  the  ladder  leaves  the  deck. 

(d)  If  the  ladder  is  recessed  under  the  deck  more  than  is  reasonably  neces- 
sary to  keep  the  ladder  clear  of  the  hatchway. 

7.  When  the  processes  are  being  carried  on  between  one  hour  after  sunset 
and  one  hour  before  sunrise,  (o)  the  places  in  the  hold  and  on  the  decks  where 
w^>rk  Is  being  carried  on  and  (6)  the  means  of  access  provided  in  pursuance  of 
regulatioM  4  and  6  shall  be  efflcientiy  lighted,  due  regard  being  had  to  the 


REPORTS    OF   THE   PRESIDENT'S  HOMES   COMMISSION.  367 

safety  of  the  ship  and  cargo,  of  all  persons  employed,  and  of  the  navigation  of 
other  vessels,  and  to  the  duly  approved  by-laws  or  regulations  of  any  authority 
having  power  by  statute  to  make  by-laws  or  regulations  subject  to  approval  by 
some  other  authority. 

8.  All  iron  fore-and-aft  beams  and  thwart-ship  beams  used  for  hatchway 
covering  shall  have  suitable  gear  for  lifting  them  on  and  off  without  it  being 
necessary  for  any  person  to  go  upon  them  to  adjust  such  gear. 

PART   in. 

9.  All  machinery  and  chains  and  other  gear  used  in  hoisting  or  lowering  in 
connection  with  the  processes  shall  have  been  tested,  and  shall  be  periodically 
examined.  All  such  chains  shall  be  effectually  softened  by  annealing  or  firing 
when  necessary,  and  all  half-inch  or  smaller  clu.ins  in  general  use  shall  be  so 
annealed  or  fired  once  in  every  six  months. 

If  the  chains  are  part  of  the  outfit  carried  by  a  seagoing  ship,  it  shall  be  a 
suflicient  compliance  with  this  regulation  as  regards  softening  by  annealing  or 
firing  of  half-inch  or  smaller  chains  that  no  such  chains  shall  be  used  unless 
they  have  been  so  annealed  or  fired  within  six  months  preceding. 

As  regards  chains,  the  safe  loads  indicated  by  the  test,  the  date  of  last  anneal- 
ing, and  any  other  particulars  prescribed  by  the  secretary  of  state,  shall  be 
entered  in  a  register  which  shall  be  kept  on  the  premises,  unless  some  other 
place  has  been  approved  in  writing  by  the  chief  inspector. 

10.  All  motors,  cogwheels,  chains  and  friction  gearing,  shafting,  and  live  elec- 
tric conductors  used  in  the  processes  shall  (unless  it  can  be  shown  that  by  their 
position  and  construction  they  are  equally  aafe  to  every  person  employed  as 
they  would  be  if  securely  fenced)  be  securely  fenced  so  far  as  is  practicable 
without  impeding  the  safe  working  of  the  ship  without  infringing  any  require- 
ment of  the  board  of  trade. 

11.  The  lever  controlling  the  link  motion  reversing  gear  of  a  crane  or  winch 
used  in  the  processes  shall  be  provided  with  a  suitable  spring  or  other  locking 
arrangement. 

12.  Every  shore  crane  used  in  the  processes  shall  have  the  safe  load  plainly 
marked  upon  it,  and  if  so  constructed  that  the  jib  may  be  raised  or  lowered 
either  shall  have  attached  to  it  an  automatic  indicator  of  safe  loads  or  shall 
have  marked  upon  it  a  table  showing  the  safe  loads  at  the  corresponding  inclina- 
tions of  the  jib. 

13.  The  driver's  platform  on  every  crane  or  tip  driven  by  mechanical  power 
and  used  in  the  processes  shall  be  securely  fenced,  and  shall  be  provided  with 
safe  means  of  access. 

14.  Adequate  measures  shall  be  taken  to  prevent  exhaust  steam  from  any 
crane  or  winch  obscuring  any  part  of  the  decks,  gangways,  wharf,  or  quay, 
where  any  person  is  employed. 

PAET    IV. 

15.  No  machinery  or  gear  used  in  the  processes,  other  than  a  crane,  shall  be 
loaded  beyond  the  safe  load;  nor  a  crane,  unless  secured  with  the  written 
permission  of  the  owner  by  plates  or  chains  or  otherwise. 

No  load  shall  be  left  suspended  from  a  crane,  windli,  or  other  machine  unless 
there  is  a  competent  person  actually  in  charge  of  the  machine  while  the  load  is 
so  left. 

16.  A  boy  under  16  shall  not  be  employed  as  driver  of  a  crane  or  winch,  or 
to  give  signals  to  a  driver,  or  to  attend  to  cargo  falls  on  winch  ends  or  winch 
bodies. 

17.  Where  in  connection  with  the  processes  goods  are  placed  on  a  wharf  or 
quay  other  than  a  wharf  or  quay  on  a  shallow  canal:  (a)  A  clear  passage  lead- 
ing to  the  means  of  access  to  the  ship  required  by  regulation  4  shall  be  main- 
tained on  the  wharf  or  quay;  and  (&)  if  any  space  is  left  along  the  edge  of  the 
wharf  or  quay,  it  shall  be  at  least  3  feet  wide  and  clear  of  all  obstructions  other 
than  fixed  structures,  plant,  and  appliances  in  use. 

18.  No  deck  stage  or  cargo  stage  shall  be  used  in  the  processes  unless  it  is 
substantially  and  firmly  constructed  and  adequately  supported,  and,  where 
necessary,  securely  fastened. 

No  truck  shall  be  used  for  carrying  cargo  between  ship  and  shore  on  a  stage 
so  steep  as  to  be  unsafe. 
Any  stage  which  is  slippery  shall  be  made  safe  by  the  use  of  sand  or  otherwise. 


338  REPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

19.  Where  there  is  more  than  one  hatchway,  if  the  hatchway  of  a  hold  exceed- 
ing 7  feet  6  inches  in  depth,  measured  from  the  top  of  the  coamings  to  the 
bottom  of  the  hold,  is  not  in  use  and  the  coamings  are  less  than  2  feet  6  inches 
in  height,  it  shall  either  be  fenced  to  a  height  of  3  feet  or  be  securely  covered. 

Provided,  That  this  regulation  shall  not  apply  during  meal  times  or  other 
temporary  interruptions  of  work  during  the  period  of  employment 

And  provided,  That  until  the  1st  of  January,  1908,  the  fending  may  be  the  best 
the  circumstances  will  allow  without  making  structural  alteration. 

Hatch  coverings  shall  not  be  used  in  connection  with  the  processes  in  the 
construction  of  deck  or  cargo  stages,  or  for  any  other  purpose  which  may 
expose  them  to  damage. 

20.  No  cargo  shall  be  loaded  by  a  fall  or  sling  at  any  intermediate  deck  unless 
a  secure  landing  platform  has  been  placed  across  the  hatchway  at  that  deck. 

PABT    V. 

21.  No  person  shall,  unless  duly  authorized,  or  In  case  of  necessity,  remove  or 
interfere  with  any  fencing,  gangway,  gear,  ladder,  life-saving  means  or  appli- 
ances, lights,  marks,  stages,  or  other  things  whatsoever,  required  by  these 
regulations  to  be  provided. 

22.  The  fencing  required  by  regulation  1  shall  not  be  removed  except  to  the 
extent  and  for  the  period  reasonably  necessary  for  carrying  on  the  work  of  the 
dock  or  ship,  or  for  repairing  any  fencing.  If  removed  it  shall  be  restored 
forthwith  at  the  end  of  that  period  by  the  persons  engaged  in  the  work  that 
necessitated  its  removal. 

PAET    VI. 

23.  No  employer  or  persons  in  the  processes  shall  allow  machinery  or  gear 
to  be  used  by  such  persons  in  the  processes  that  does  not  comply  with  Part  III 
of  these  regulations. 

24.  If  the  persons  whose  duty  it  is  to  comply  with  regulations  4,  5,  and  7  fail 
so  to  do,  then  it  shall  also  be  the  duty  of  the  employers  of  the  persons  employed 
for  whose  use  the  means  of  access  and  the  lights  are  required  to  comply  with 
the  said  regulation  within  the  shortest  time  reasonably  practicable  after  such 
faih  re. 

2o.  The  certificate  of  the  ship's  register  and  any  other  certificate  or  register 
referred  to  in  these  regulations  shall  be  produced  by  the  person  in  charge 
thereof  on  the  application  of  any  of  His  Majesty's  inspectors  of  factories. 

A.  Akebs-Douglas, 
One  of  His  Majesty's  Principal  Secretaries  of  State, 
Home  Office,  Whitehall,  24th  October,  1904. 

Factoby  Engines  and  Cabs. 

Whereas  the  nse  of  locomotives,  wagons,  and  other  rolling  stock  on  lines  of 
rail  or  sidings  in  any  factory  or  workshop  or  any  place  to  which  the  provisions 
of  section  79  of  the  factory  and  workshop  act,  1901,  are  applied  by  that  act,  or 
on  lines  of  rail  or  sidings  used  in  connection  with  any  factory  or  workshop  or 
any  place  as  aforesaid,  and  not  being  part  of  a  railway  within  the  meaning  of 
the  railway  employment  (preventions  of  accidents)  acts,  1900,  has  been  certified 
in  pursuance  of  the  said  section  to  be  dangerous: 

I  hereby,  in  pursuance  of  the  powers  conferred  upon  me  by  that  act,  make 
the  following  regulations  and  direct  that  they  shall  apply  to  all  places  before 
mentioned. 

These  regulations  shall  come  into  force  on  the  1st  day  of  January,  1907, 
except  regulations  1,  2,  and  22,  which  shall  come  into  force  on  the  1st  day  of 
January,  1908. 

Subject  to  the  exemptions  below,  it  shall  be  the  duty  of— (i)  The  occupier  of 
any  factory  or  workshop  and  any  place  to  which  any  of  the  provisions  of  the 
factory  and  workshop  act,  1901,  are  applied,  and  (n)  the  occupier  of  any  line 
of  rails  or  sidings  used  in  connection  with  a  factory  or  workshop,  or  with  any 
place  to  which  any  of  the  provisions  of  the  factory  and  workshop  act,  1901,  are 
applied,  to  comply  with  Part  I  of  these  regulations. 

And  It  shall  be  the  duty  of  every  person  who  by  himself,  his  agents  or  work- 
men, carries  on  any  of  the  operations  to  which  these  regulations  apply,  and  of 


REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  369 

all  agents,  workmen,  and  persons  employed  to  comply  with  Part  II  of  these 
regulations. 

And  it  shall  be  the  duty  of  every  person  who  by  himself,  his  agents,  or  work- 
men, carries  on  any  of  the  operations  to  which  these  regulations  apply,  to  com- 
ply with  Part  III  of  these  regulations. 

In  these  regulations  : 

Line  of  rails  means  a  line  of  rails  or  sidings  for  the  use  of  locomotives  or 
wagons  excepting  such  lines  as  are  used  exclusively  for  (a)  a  gantry  crane  or 
traveling  crane,  or  (b)  any  charging  machine  or  other  apparatus  or  vehicle  used 
exclusively  in  or  about  any  actual  process  or  manufacture. 

Wagon  includes  any  wheeled  vehicle  or  nonself-moving  crane  on  a  line  of 
rails. 

Locomotive  includes  any  wheeled  motor  on  a  line  of  rails  used  for  the  move- 
ment of  wagons  and  any  self-moving  crane. 

Gantry  means  an  elevated  structure  of  wood,  masonry,  or  metal,  exceeding  6 
feet  in  height  and  used  for  loading  or  unloading,  which  carries  a  line  of  rails, 
whereon  wagons  are  worked  by  mechanical  power. 

Nothing  in  these  regulations  shall  apply  to: 

(a)  A  line  of  rails  of  less  than  3  feet  gauge,  and  locomotives  and  wagons 
used  thereon. 

(6)  A  line  of  rails  not  worked  by  mechanical  power. 

(c)  A  line  of  rails  inside  a  railway  goods  warehouse. 

(d)  A  line  of  rails  forming  part  of  a  mine  within  the  meaning  of  the  coal 
mines  regulation  act,  1887,  or  of  a  quarry  within  the  meaning  of  the  quarries 
act,  1894,  not  being  a  line  of  rails  within  or  used  solely  in  connection  with  any 
factory  or  workshop  not  incidental  to  the  maintenance  or  working  of  the  mine 
or  quarry  or  to  the  carrying  on  of  the  business  thereof. 

(e)  Pit  banks  or  mines  to  which  the  metaliferous  mines  regulation  act,  1872, 
applies,  and  private  lines  of  rails  used  in  connection  therewith. 

(/)  Lines  of  rails  used  in  connection  with  factories  or  workshops,  so  far  as 
they  are  outside  the  factory  or  workshop  premises,  and  used  for  running  pur- 
poses only. 

(g)  Wagons  not  moved  by  mechanical  power. 

(h)  Buildings  in  course  of  construction. 

(i)  Explosive  factories  or  workshops  within  the  meaning  of  the  explosives 
act,  1875. 

ij)  All  lines  and  sidings  on  or  used  in  connection  with  docks,  wharves,  and 
quays  not  forming  part  of  a  factory  or  workshop  as  defined  in  section  149  of  the 
factory  and  workshop  act,  1901. 

(k)  Wagon  or  locomotive  building  or  repairing  shops,  and  all  lines  and  sidings 
used  in  connection  with  such  shops  if  such  shops  are  in  the  occupation  of  a  rail- 
way company  within  the  meaning  of  the  regulation  of  railways  act,  1871. 

(I)  Depots  or  car  sheds  being  parts  of  tramways  or  light  railway  undertak- 
ings authorized  by  Parliament,  and  used  for  the  storage,  cleaning,  inspection, 
or  repair  of  tramway  cars  or  light  railway  cars. 

PABT  I. 

1.  Point  rods  and  signal  wires  in  such  a  position  as  to  be  a  source  of  danger 
to  persons  employed  shall  be  sufficiently  covered  or  otherwise  guarded. 

2.  Ground  levers  working  points  shall  be  so  placed  that  men  working  them 
are  clear  of  adjacent  lines,  and  shall  be  placed  in  a  position  parallel  to  the  adja- 
cent lines,  or  In  such  other  position,  and  be  of  such  form  as  to  cause  as  little 
obstruction  as  possible  to  persons  employed. 

3.  Lines  of  rails  and  points  shall  be  periodically  examined  and  kept  in  efficient 
order,  having  regard  to  the  nature  of  the  traffic. 

4.  Every  gantry  shall  be  properly  constructed  and  kept  in  proper  repair.  It 
shall  have  a  properly  fixed  structure  to  act  as  a  stop-block  at  any  terminal 
point;  and  at  every  part  where  persons  employed  have  to  work  or  pass  on  foot 
there  shall  be  a  suitable  footway,  and  if  such  footway  is  provided  between  a  line 
of  rails  and  the  edge  of  the  gantry  the  same  shall,  so  far  as  is  reasonably 
practicable,  having  regard  to  the  traffic  and  working,  be  securely  fenced  at  such 
a  distance  from  the  line  of  rails  as  to  afford  a  reasonably  sufficient  space  for 
such  persons  to  pass  in  safety  between  the  fence  and  a  locomotive,  wagon,  or 
load  on  the  line  of  rails. 

S.  Doc.  644,  60-2 25 


370  EEPORTS  OF   THE  PRESIDENT'S  HOMES  COMMISSION. 

5.  Coupling  poles  or  other  suitable  mechanical  appliances  shall  be  provided 
where  required  for  the  purpose  of  regulation  11. 

6.  Proper  sprags  and  scrotches,  when  required,  shall  be  provided  for  the  use 
of  persons  in  charge  of  the  movement  of  wagons. 

7.  Where,  during  the  period  between  one  hour  after  sunset  and  one  hour  be- 
fore sunrise,  or  in  foggy  weather,  shunting  or  any  operations  likely  to  cause 
danger  to  persons  employed  are  frequently  carried  on,  efficient  lighting  shall  be 
provided  either  by  hand  lamps  or  stationary  lights,  as  the  case  may  require,  at 
all  points  where  necessary  for  the  safety  of  such  persons. 

8.  The  mechanism  of  a  capstan  worked  by  power  and  used  for  the  purpose  of 
traction  of  wagons  on  a  line  of  rails  shall  be  maintained  in  efficient  condition, 
and  if  operated  by  a  treadle,  such  treadle  shall  be  tested  daily  before  use. 

PAST  II. 

9.  When  materials  are  placed  within  3  feet  of  a  line  of  rails  and  persons  em- 
ployed are  exposed  to  risk  or  injury  from  traffic  by  having  to  pass  on  foot  over 
them  or  between  them  and  the  line,  such  material  shall,  as  far  as  reasonably 
practicable,  be  so  placed  as  not  to  endanger  such  persons,  and  there  shall  be 
adequate  recesses  at  intervals  of  not  more  than  20  yards  where  the  materials 
exceed  that  length. 

10.  No  person  shall  cross  a  line  of  rails  by  crawling  or  passing  underneath  a 
train  or  wagons  thereon  where  there  may  be  a  risk  of  danger  from  traffic. 

11.  Locomotives  or  wagons  shall  wherever  it  is  reasonably  practicable  without 
structural  alterations  be  coupled  or  uncoupled  only  by  means  of  a  coupling  pole 
or  other  suitable  mechanical  appliance,  except  where  the  construction  of  loco- 
motives or  wagons  is  such  that  coupling  or  uncoupling  can  be  safely  and  con- 
veniently performed  without  any  part  of  a  man's  body  being  within  the  space 
between  the  ends  or  buffers  of  one  locomotive  or  wagon  and  another. 

12.  Sprags  and  scrotches  shall  be  used  as  and  when  they  are  required. 

13.  Wagons  shall  not  be  moved  or  be  allowed  to  be  moved  on  a  line  of  rails 
by  means  of  a  prop  or  pole,  or  by  means  of  towing  by  a  rope  or  chain  attached 
to  a  locomotive  or  wagon  moving  on  an  adjacent  line  of  rails  when  other  rea- 
sonably practicable  means  can  be  adopted;  provided  that  this  shall  not  apply 
to  the  movement  of  ladles  containing  hot  material  on  a  line  of  rails  in  front  of 
and  adjacent  to  a  furnace. 

In  no  case  shall  props  be  used  for  the  above  purpose  unless  made  of  iron, 
steel,  or  strong  timber,  hooped  with  iron  to  prevent  splitting. 

14.  Where  a  locomotive  pushes  more  than  one  wagon,  and  risk  of  injury  may 
thereby  be  caused  to  persons  employed,  a  man  shall,  wherever  it  is  safe  and  rea- 
sonably practicable,  accompany  or  precede  the  front  wagon  or  other  efficient 
means  shall  be  taken  to  obviate  such  risk. 

Provided  that  this  regulation  shall  not  apply  to  the  following : 
(a)  Fly  shunting. 

(6)  Movement  of  wagons  used  for  conveyance  of  molten  or  hot  material  or 
other  dangerous  substance. 

15.  No  person  shall  be  upon  the  buffer  of  a  locomotive  or  wagon  in  motion 
unless  there  is  a  secure  handhold,  and  shall  not  stand  thereon  unless  there  Is 
also  a  secure  foot  place ;  nor  shall  any  person  ride  on  a  locomotive  or  wagon  by 
means  of  a  coupling  pole  or  other  like  appliance. 

16.  No  locomotive  or  wagon  shall  be  moved  on  a  line  of  rails  until  warning 
has  been  given  by  the  person  in  charge  to  persons  employed  whose  safety  is 
likely  to  be  endangered. 

Provided  that  this  regulation  shall  not  apply  to  a  self-moving  crane  within  a 
building  or  to  a  charging  machine  or  other  vehicle  so  long  as  it  is  used  in  or 
about  any  actual  process  of  manufacture. 

17.  Where  persons  employed  have  to  pass  on  foot  or  work,  no  locomotive  or 
wagon  shall  be  moved  on  a  line  of  rails  during  the  period  between  one  hour 
after  sunset  and  one  hour  before  sunrise,  or  in  foggy  weather,  unless  the  ap- 
proaching end,  wherever  it  Is  safe  and  reasonably  practicable,  is  distinguished 
by  a  suitable  light  or  accompanied  by  a  man  with  a  lamp. 

Provided  that  this  regulation  shall  not  apply  to  the  movement  of  locomotivea 
or  wagons  within  any  area  which  is  efficiently  lighted  by  stationary  lights. 

18.  The  driver  In  charge  of  a  locomotive,  or  a  man  preceding  it  on  foot,  shall 
give  an  efficient  sound  signal  as  a  warning  on  approaching  any  level  crossing 
over  a  line  of  rails  regularly  used  by  persons  employed,  or  any  curve  where 
Bight  Is  Intercepted,  or  any  other  point  of  danger  to  persons  employed. 


BEPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  371 

19.  A  danger  signal  shall  be  exhibited  at  or  near  the  ends  of  any  wagon  or 
train  of  wagons  undergoing  repair  wherever  persons  employed  are  liable  to  be 
endangered  by  an  approaching  locomotive  or  wagon. 

20.  (a)  The  space  immediately  around  such  capstan  as  mentioned  in  regula- 
tion 8  shall  be  kept  clear  of  all  obstruction. 

(&)  Such  capstan  shall  not  be  set  in  motion  until  signals  have  been  exchanged 
between  the  man  in  charge  of  the  capstan  and  the  man  working  the  rope  or 
chain  attached  to  it. 

(c)  No  person  under  18  years  of  age  shall  work  such  capstan. 

21.  No  person  under  the  age  of  18  shall  be  employed  as  a  locomotive  driver, 
and  no  person  under  the  age  of  16  shall  be  employed  as  a  shunter. 

PAST  m. 

22.  All  glass  tubes  or  water  gauges  on  locomotives  or  stationary  boilers  used 
for  the  movement  of  wagons  shall  be  adequately  protected  by  a  covering  or 
guard. 

H.  J.  Gladstone, 
One  of  His  Majesty's  Princvpal  Secretaries  of  State, 
Home  Omca,  Whitehall,  S4th  August,  1906. 


Appendix  C. 

The  following  is  a  letter  received  from  Prof.  H.  W.  Wiley,  Bureau  of  Chem- 
istry, United  States  Department  of  Agriculture  : 

Washington,  D.  C,  November  4,  1908. 
Mr.  George  M.  Kober, 

923  H  Street  NW.,  Washington,  D.  C. 

Dear  Sir  :  Your  favor  of  October  27  at  hand,  and  in  reply  desire  to  state  that 
the  question  of  drug  habit  has  received  considerable  attention  by  the  division 
of  drugs,  and  could  place  at  your  disposal  much  valuable  information.  We  are 
collecting  this  information  as  rapidly  as  possible  and  expect  in  the  near  future 
to  submit  to  the  Secretary  for  approval  and  publication  a  bulletin  dealing  with 
acetanilid,  antipyrin,  and  phenacetin. 

We  also  are  in  possession  of  information  as  to  the  institutions  and  their  meth- 
ods of  treating  unfortunate  drug  habitues,  particularly  those  addicted  to  the 
use  of  opium,  morphine,  cocaine,  etc. 

I  am  inclosing  copies  of  two  bills  which  were  introduced  at  the  last  session  of 
Congress.  The  object  of  these  bills  is  to  regulate  and  minimize  the  evil  at  pres- 
ent resulting  from  the  indiscriminate  sale  and  use  of  the  agents  enumerated 
therein.  If  you  could  make  it  convenient  to  visit  the  drug  laboratory  of  this 
bureau  we  would  be  in  a  position  to  place  at  your  disposal  much  information 
which  would  be  of  great  assistance  to  you  in  your  work. 
Respectfully, 

H.  W.  WiLirr,  Chief. 

The  following  is  a  letter  received  from  Dr.  Lyman  F.  Kebler,  chief,  division 
of  drugs,  United  States  Department  of  Agriculture: 

Washington,  D.  C,  Novemher  21,  1908, 
Dr.  George  M.  Kobeb, 

1819  Q  Street,  Washington,  D.  0. 
Dear  Sir:  I  am  herewith  transmitting  data  on  the  following  subjects:  The 
harmful  effects  of  acetanilid,  antipyrin,  and  acetphenetidin  (phenacetin) ;  can- 
cer cures ;  female  pills ;  soft  drinks  containing  caffeine,  etc. ;  the  dope  question ; 
consumption  cures;  habit  cures,  and  prescription  nostrums.  I  did  not  include 
the  list  of  headache  remedies,  for  the  reason  that  they  are  not  as  yet  complete. 
We  have  found  approximately  365  which  have  a  fairly  large  sale — that  is,  more 
than  the  local  sale  of  a  drug  store — but  not  more  than  one-half  of  same  have  been 
investigated  in  the  division  of  drugs.  I  shall  be  pleased  to  forward  you  the 
entire  list,  with  the  understanding  that  there  might  be  one  or  two  which  are 
not  actually  headache  remedies,  but  are  believed  to  be  such  from  the  trading 
name. 

Respectfully,  L.  P.  Kebler, 

Chief,  Division  of  Drugs. 


372  REPORTS  OF  THE  PRESIDENT'S  HOMES  COMMISSION. 

SOFT  DBINKS    CONTAINING    CAFFEINE   AND   EXTRACTS    OF    COCA   LEAF   AND    KOLA    NUT. 

[By  LxHAV  F.  Kbblbb,  M.  D.,  Ph.  D.,  Chief,  Division  of  Drugs,  U.  S.  Department  of 

Agriculture.] 

During  the  past  decade  soda-fountain  specialties  containing  cafifeine,  extract 
of  kola  nut  and  extract  of  coca  leaf,  the  active  principle  of  which  is  cocaine, 
have  been  offered  in  considerable  quantities  and,  due  to  extensive  and  attractive 
advertising,  both  as  beverages  and  as  headache  remedies  and  nerve  tonics, 
their  sale  has  assumed  large  proportions. 

The  first  appearance  of  preparations  of  this  type  was  in  the  South  in  the 
eighties,  their  introduction  following  the  success  which  Moxie  had  attained  in 
the  East,  though  this  particular  drinli  was  of  an  entirely  different  character. 
From  the  South  the  demand  spread  to  other  sections  and  the  number  of  products 
has  increased  until  at  the  present  time  there  are  probably  over  one  hundred  of 
them  bottled  and  sold  all  over  the  United  States.  The  greatest  demand  is  still 
in  the  South,  however,  and  almost  every  drug  store,  confectionery  shop,  and 
fruit  stand  has  its  favorite  product  on  sale.  The  carbonated  goods  in  bottled 
form  are  offered  on  the  trains.  People  of  all  classes,  young  and  old,  delicate 
women,  and  even  little  children  consume  these  beverages  indiscriminately  and 
no  warning  is  ever  given  of  the  baneful  effect  of  the  powerful  habit-forming 
drugs  concealed  therein.  It  is  therefore  small  wonder  that  the  prevalence  of 
the  so-called  "coca  cola  fiend"  is  becoming  a  matter  of  great  importance  and 
concern. 

It  is  well  known  that  some  of  these  products  are  mixed  under  the  most  un- 
sanitary conditions.  The  sugar,  water,  and  drug  material  will  be  dumped  into 
a  pot  standing  in  the  cellar  of  some  low  building,  or  even  a  stable,  where  the 
ceiling  is  covered  with  dust,  cobwebs,  and  dirt  of  all  descriptions  and  the  floor 
littered  with  filth.  The  steam  from  the  boiling  kettle,  condensing  on  the  ceiling, 
collects  the  dirt  in  the  drops  of  water  and  this  soon  falls  back  into  the  mixture. 
Again,  the  sirup  will  boil  over  onto  the  floor  and  a  sticky  mass  remains  which 
soon  collects  straw  and  filth  of  all  descriptions  and  becomes  a  rendezvous  for 
flies  and  other  vermin,  for  usually  no  attempt  is  made  to  clean  it  up. 

Judging  from  the  names  of  most  of  these  products  it  would  appear  that  ex- 
tract of  kola  nut  is  one  of  the  chief  ingredients,  and,  while  in  certain  instances 
this  drug  is  undoubtedly  present,  in  most  cases  the  caffeine  has  been  added  as 
the  alkaloid  caffeine  obtained  from  refuse  tea  sweepings  or  made  artificialy 
from  uric  acid  occurring  in  the  Guano  deposits  of  South  America,  or  in  the 
citrated  form,  and  the  sirup  colored  with  caramel.  The  cocaine  found  is  usually 
added  in  the  form  of  extract  of  coca  leaf.  Some  of  the  manufacturers  claim 
that  the  extract  used  is  prepared  from  a  decocainized  coca  leaf,  the  refuse  prod- 
uct discarded  in  the  manufacture  of  cocaine. 

An  investigation  of  these  products  was  undertaken  about  a  year  ago  and  it 
was  found  ttiat  the  following  products  contained  both  caffeine  and  extract  of 
coca  leaf: 

Afri  CJola,  The  Afri  Cola  Co.,  Atlanta,  Ga. 

Ala  Cola,  Ala  Bottling  Works,  Bessemer,  Ala. 

Cafe  Coca,  Athens  Bottlmg  Works,  Athens,  Ga. 

Carre  Cola,  R  Carre  Co.,  Mobile,  Ala. 

Celery  Cola,  The  Celery  Cola  Co.,  Birmingham,  Ala. ;  Dallas,  Tex. ;  Nash- 
ville, Tenn.,  and  St  Louis,  Mo. 

Chan  Ola,  L.  M.  Channell,  New  Orleans,  La. 

Chera  Cola,  Union  Bottling  Works,  Columbus,  Ga. 

Coca  Beta,  the  Coca  Beta  Co.,  New  York  City. 

Coca  Beta,  Southern  California  Supply  Co.,  Los  Angeles,  CaL 

Coca  Cola,  Coca  Cola  Co.,  Atlanta,  Ga. 

Pilsbury's  Coke,  A.  L.  Pilsbury,  jr.,  Co.,  New  Orleans,  La. 

Cola  Coke,  Lehman-Rosenfeld  Co.,  Cincinnati,  Ohio.     (This  preparation 
was  formerly  sold  under  the  name  of  Rocco  Cola.) 

Cream  Cola,  Jebeles  &  Calias  Co.,  Birmingham,  Ala. 

Dope,  Rainbow  Bottling  Co.,  Atlanta,  Ga. 

Four  Kola,  Big  Four  Bottling  Works,  Waco,  Tex, 

Hayo  Kola,  Hayo  Kola  Co.,  Norfolk,  Va. 

Heck's  Cola,  Heck  &  Co.,  Nashville,  Tenn. 

Kaye  Ola,  A.  W.  Kaye,  Meridian,  Miss. 

Koca  Nola,  Koca  Nola  Co.,  Altanta,  Ga. 

Koke,  Coleman  &  McKeever,  Frankfort,  Ky. 


REPORTS   OF   THE  PRESIDENT'S  HOMES  COMMISSION.  373 

Kola  Ade,  Wiley  Manufacturing  Co.,  Atlanta,  Ga, 

Kola  Kola,  W.  J.  Stange  Ck).,  Chicago,  111. 

Kola  Phos,  John  Wyeth  &  Bro.,  Philadelphia,  Pa. 

Koloko,  Halberg  Bottling  Works,  Mobile,  Ala. 

Kos  Kola,  Sethness  Co.,  Chicago,  111. 

Lime  Cola,  Alabama  Grocery  Co.,  Birmingham,  Ala. 

Lima  Ola,  Wine  Brew  Co.,  Macon,  Ga. 

Mellow  Nip,  Rainbow  Bottling  Co.,  Atlanta,  Ga. 

Nerv  Ola,  Henry  K.  Wampole  &  Co.,  Philadelphia,  Pa. 

Revive  Ola,  O.  L.  Gregory  Vinegar  Co.,  Birmingham,  Ala. 

Rocola,  American  Manufacturing  Co.,  Savannah,  Ga. 

Rye  Ola,  Rye  Ola  Co.,  Birmingham,  Ala. 

Standard  Cola,  The  Standard  Bottling  Co.,  Denver,  Colo. 

Toka  Tona,  California  Commercial  Co.,  Los  Angeles,  CaL 

Tokola,  Samuel  Smith  &  Co.,  Chicago,  111. 

Vani  Kola,  Vani  Kola  Company,  Canton,  Ohio. 

Vim-0,  Vim-0  Company,  Eagle  Lake,  Tex. 

French  Wine  of  Coca,  Wine  of  Coca  Co.,  Boston,  Mass. 

Wise  Ola,  The  Wise  Ola  Co.,  Birmingham,  Ala. 
The  following  preparations  were  found  to  contain  caffeine,  but  there  was  no 
evidence  to  the  effect  that  coca  leaf  in  any  form  had  been  used  in  their  manu- 
facture : 

Calycine,  Calycine  Co.,  Norfolk,  Va. 

Celery  Cocoa,  Celery  Cocoa  Co.,  Los  Angeles,  Cal, 

Citro  Cola,  Miners  Fruit  Nectar  Co.,  Boston,  Mass. 

Deep  Rock  Ginger  Ale,  Abney  Bros.,  Athens,  Ga. 

Fosko,  E.  Carre  Co.,  Mobile,  Ala. 

Heck's  Star  Pepsin,  Mrs.  Ida  Heck,  Nashville,  Tenn. 

Koke,  Coan  &  Harbin,  Bluff  City  Bottling  Co.,  Memphis,  Tenn. 

Koke  Ola,  Eagle  Bottling  Co.,  Frankfort,  Ky. 

Kalafra,  Mead  Johnson  Co.,  Jersey  City,  N.  J. 

Kumfort,  The  Kumfort  Co.,  Atlanta,  Ga. 

Lime  Juice  and  Kola,  Parke  Davis  &  Co.,  Detroit,  Miclu 

Lon  Kola,  Lon  Kola  Co.,  Danville,  Ky. 

Meg-0,  Parr  Bros.,  Baltimore,  Md. 

Mexicola,  Celiko  Bottling  Works,  Raleigh,  N.  C. 

Pau  Pau  Cola,  Pau  Pau  Cola  Co.,  Detroit,  Mich. 

Pedro,  N.  J.  Parker  &  Co.,  Washington,  D.  C. 

Pepsi  Cola,  C.  D.  Bradham,  New  Bern,  N  C. 

Speed  Ball,  E.  Pilzer,  Speed  Ball  Co.   (Inc.),  Washington,  D.  C 

To-Ko,  The  To-Ko  Company,  Hagerstown,  Md. 

Vril,  Brand  Bros.,  Chicago,  111. 
Besides  the  above  preparations  which  have  been  analyzed  a  number  were 
reported  from  different  parts  of  the  country  but  no  samples  were  submitted. 
From  their  names,  and  from  what  evidence  there  waa  submitted,  they  contain 
either  caffeine  of  coca  leaf  extract,  or  both: 

Charcola,  H.  C.  Metzger,  Meridian,  Miss. 

Cherry  Kola,  Williamsport,  Pa. 

Cola  Soda,  Jacob  House  &  Sons,  Buffalo,  N.  T. 

Coca  Ginger,  National  Beverage  Co.,  Atlanta  and  Chattanooga. 

Field's  Cola,  H.  C.  Field,  High  Point,  N.  C. 

Imported     French     Cola,     Alabama     Grocery     Co.,     Birmingham,    Ala. 
( Claimed  to  be  carbonated  Wiseola.) 

Jacob's  Kola,  Tampa,  Fla. 

Koko  Ale,  Salt  Lake  City  Soda  Water  Co.,  Salt  Lake  City. 

Kola  Cream,  The  Henzerling  Co.,  Baltimore,  Md. 

Kola  Pepsin  Celery  Wine  Tonic,  W.  J.  Miller,  Cleveland,  Ohio. 

Kola  Vena. 

Loco  Kola,  Norton,  Va. 

Mintola,  Davis  Kelley  Co.,  Louisville,  Ky. 

Mate,  Mississippi  Ice  Co.,  Clarksdale,  Miss. 

Pikmeup,  Scales,  Wilson  Co.,  Greenville,  S.  C 

Ro-Cola,  Savannah,  Ga. 

Schelhorns  Cola,  Evansville  Bottling  Co.,  Evansville,  Ind. 

Vine  Cola,  California  Commercial  Co.,  Los  Angeles,  Cal. 

Viz,  Alabama  Grocery  Co.,  Birmingham,  Ala.     (Claimed  to  be  carbon- 
ated Wiseola.) 


374  EEPOBTS   OF   THE   PRESIDENT  S   HOMES   COMMISSION. 

HABIT   CUBES. 

[By  Ltman  F.  Keblke,  M.  D.,  Fh.  D.,  Chief,  Division  of  Drugs,  U.  S.  Department  of 

Agriculture.  ] 

Nostrums  for  the  cure  of  the  drug  and  liquor  habits  are  widely  advertised 
throughout  the  country  in  the  public  press.  A  request  for  further  information 
with  regard  to  the  subject  of  one  of  the  advertisements  is  followed  by  the  receipt 
of  printed  matter  setting  forth  the  virtues  of  the  remedy,  and  a  "  symptom 
blank  "  whereon  the  inquirer  is  expected  to  state  over  his  signature  the  kind 
of  drug  he  is  using  and  the  dose  which  he  is  accustomed  to  take  daily.  Upon 
returning  this  blank,  filled  out,  the  inquirer  is  informed  as  to  the  price  at  which 
the  remedy  in  quesion  can  be  procured.  This  is  usually  at  a  specified  price  per 
bottle,  or  treatment,  treatment  being  reckoned  by  the  month.  Some  concerns 
do  not  employ  the  symptom  blank,  but  sell  their  products  to  all  who  apply, 
without  question.  In  almost  every  case  the  remedy  contains  a  generous  pro- 
portion of  an  opiate,  usually  in  the  form  of  morphine.  Ostensibly  the  treat- 
ment is  based  upon  the  reduction  plan;  the  patient  is  advised  to  give  up  the 
use  of  the  drug  which  he  was  formerly  taking  and  to  depend  entirely  upon  the 
remedy,  and  to  reduce  the  daily  dose  of  this  at  regular  intervals  until  he  finally 
does  away  with  its  use  entirely.  This,  as  a  matter  of  fact,  he  never  does, 
because  he  finds  it  just  as  diflicult  to  break  away  from  the  morphine-containing 
"support"  as  from  the  straight  morphine  which  he  formerly  took.  Meantime 
the  concern  which  furnishes  the  nostrum  reaps  pecuniary  benefit. 

Most  of  the  nostrums  for  the  cure  of  the  liquor  habit  depend  for  their  efficacy 
upon  the  nauseating  qualities  of  the  ingredients  which  they  contain.  *  *  ♦ 
The  remedy  can  be  taken  voluntarily  by  the  patient  himself,  or  administered 
secretly  by  introducing  it  surreptitiously  into  his  food  or  drink.  Promises  of  a 
most  alluring  character  are  held  out  with  regard  to  the  latter  method  of  admin- 
istration, and  the  wives  and  mothers  of  drunkards  have  been  known  to  go  great 
lengths  to  procure  the  money  wherewith  to  purchase  these  nostrums.  The 
result  of  both  methods  of  administration  is  the  same — the  patient's  stomach 
and  digestion  are  injured,  perhaps  permanently,  and  no  real  good  is  accom- 
plished.   A  list  of  the  "  cures  "  for  the  drug  and  alcohol  habit  is  given  below. 

HABITS. 

Drug  cures, 

W.  J.  Carney,  567  Lebanon  street,  Melrose,  Mass.     (Opium.) 

St.  Paul  Association,  46-48  Van  Buren  street,  Chicago.     (Drugs.) 

Purdy  Sanitarium,  614^  Fannin  street,  Houston,  Tex. 

Harris  Institute,  400  West  Twenty-third  street.  New  York.     (Drugs.) 

O.    P.    Coates    Co.,    917-919    New    York    Life    Building,    Kansas    City. 

(Drugs.)     Habitina. 
Dr.   Stewart-Hord   Sanitarium,  360  Franklin   avenue,   Shelbyville,   Ind. 

(Drugs.) 
Waterman  Institute,  14-18  Lexington  avenue,  New  York.     (Drugs.) 
Cedarcroft  Sanitarium,  Lebanon,  Tenn. 
New  Malay  Opium  Cure,  Rev.  J.  C.  Ives,  134  East  Twenty-fifth  street, 

New  York. 
•*99"   Morphine  &   Opium  Cure,   Krouskeep,   Clark  and   Van   Buren 

streets,  Chicago. 
St.  James  Society,  Suite  245,  1181  Broadway,  New  York.     (Drugs.) 
Manine  Medical  Co.,  3201  Locust  street,  St.  Louis.     (Drugs.) 
B.  M.  Wolley  Co.,  Atlanta,  Ga.,  Box  887.     (Opium,  whisky,  etc.) 
Alexand^  Cooperative  Sanitarium  Co.,  Fulton,  Ky. 
Dr.  W.  A.  Steams,  Atlanta,  Ga. 
Dr.  W.  J.  Tucker,  Atlanta,  Ga. 
Dr.  L.  F.  Myers,  Columbus,  Ga. 
Dr.  G.  W.  D.  Patterson,  Atlanta,  Ga. 
The  Acme  Opium  Cure,  Kirk  wood,  Ga. 
James  Sanitarium,  Memphis,  Tenn. 
Drug  Crave  Crusade,  41  Union  Square,  New  York. 
Dr.  J.  L.  Stevens  Co.,  Lebanon,  Ohio.     Hyoscin. 
Comstock  Remedy  Co.,  Lafayette,  Ind.     (Fluid  Extract  Coca.) 
National  Aid  Society,  134  East  Twenty-fifth  street.  New  York. 


REPORTS    OF    THE   PRESIDENT  S   HOMES    COMMISSION. 


376 


Windsor  Laboratories,  134  East  Twenty-fifth  street,  Yew  York.    Malay 

Opium  Co. 
Ricbie  Co.,  105  St.  James  Place,  Brooklyn,  N.  Y. 
Mackay  Treatment  Co.,  61  Maiden  Lane,  New  York. 
Scientific  Remedy  Co.,  45  West  Thirty-fourth  street,  New  York. 
Oppenheimer  Institute,  159  West  Thirty-fourth  street,  New  York. 
Mrs.  Carney,  567  Lebanon  street,  Melrose,  Mass. 
World  Remedy  Co.,  Syracuse,  N.  Y. 
H.  C.  Keith,  Losantville,  Ind, 

The  Dr.  Koonse  Cure,  812  Calbtun  street.  Ft.  Wayne,  Ind. 
Compound  Oxygen  Association,  125  Douglas  avenue,  Ft.  Wayne,  Ind. 
Awaine's  Antidote  Sanitarium,  Cleveland,  Ohio,  3731  Cedar  avenue. 
Dr.  Rutledge  Medical  Institute,  477  Ellicott  Square,  Buffalo,  N.  Y. 
Lanoix  Cure  Co.,  Kansas  City,  Mo. 
Dr.  W.  J.  McKanna,  Reidsville,  N.  C. 
Delta  Chemical  Co..  St.  Louis,  Mo. 

AlcohoL 

Orrine.     (Alcohol.) 

White  Ribbon  Remedy  Co.,  218  Tremont  street,  Bdston. 

Dr.  J.  W.  Haines,  1515  Gleen  Building,  Cincinnati,  Ohio. 

The  Dr.  Brannaman  Cure,  210  Chaman  Building,  Kansas  City. 

Aur-Mon-0,  110  West  Thirty-fourth  street.  New  York. 

James  Sanitorium,  Memphis,  Tenn. 

Mrs.  Margaret  Anderson,  512  Home  avenue,  Hillburn,  N.  Y. 

Physicians  Co-operative  Association,  Chicago. 

Parker  Willis,  16  State  Life  building,  Indianapolis,  Ind. 

Kansas  Anti-Liquor  Society,  601  Gray  Buildings,  Kansas  City. 

Trunk  Bros.  Drug  Co.,  400-402  Sixteenth  street,  Denver,  Colo. (Ciga- 
rette habit.) 

Rogers  Drug  &  Chemical  Co.,  "Easy  to  Quit,"  1982  Fifth  and  Race 
streets,  Cincinnati. 

DE.  KEBLEE'S  list  OF  HEADACHE  BEMEDIES. 


A.  B.  C.  Headache  Powders. 
Acetafein   (O.  C.  &  Son). 
Acetalix. 

Acetanilide  Comp.  U.  S.  P. 
Acetanol.    Headache  Powders. 
Ache-Head. 

Acme  Headache  Wafers. 
A.  D.  S.  Headache  Wafers. 
Dr.  Agnew's  Headache  Tablets. 
Ake-in-the-Head-Tablets. 
Alex  Harmless  Headache  Powders. 
Allen's  Headache  Powders. 
Alpha  Headache  Wafers. 
Ammonol. 

Analgia  (Merrell's)  Tablets. 
Analgine. 

Anti-headache  ( Davis ) . 
Anti-Headache  Moroneys. 
Antikamnia. 

Anthony's  Headache  Powders. 
Anti-Pain  Pills. 

Armstrong's  Headache  Powder. 
Atkinson's  "99." 
Babcock's  Headache  Pills. 
"  Bar-Ben  "  Formula  A,  for  headache. 
Barton's  Headache  Powders. 
Beck's  Little  Wonder  Headache  Pow- 
ders. 
Beck's  Universal  Headache  Tablets. 
Beekman  Headache  Wafers. 
Bell's  Coryza  Tablets. 


Bensen's  Headache  Powders. 

B enter's  Headache  Powders. 

Bergwall's  Acme  Headache  Wafers. 

Big  4  Headache  Powders. 

Billington's  Headache  Powder. 

Bi-Lo-Zone. 

Bird's  Headache  Tablets. 

Block's  Headache  Cure. 

Dr.  Bob's  Headache  Powder. 

Dr.  Bonker's  Headache  Powder. 

Bouchard's  Capsules. 

Boulanger's  Headache  Cure. 

Bovine  Headache  Powder. 

Brain  Food.     (Harper's.) 

Brangeine. 

Brant's  Headache  Tablets. 

Brazilian     Compound     Anti-Headache 

Tablets. 
Broa's  Headache  Powders. 
Bromo  Caffeine.    (K.  &  M.) 
Bromo-Celery.     ( Arnold. ) 
Bromo  Compound.     (Arnold's.) 
Bromodine  for  Headache. 
Bromo-kamnia. 
Bromoline. 
Bromo  Lithia. 
Bromonia. 

Bromo-QHinine-Laxative. 
Bromo- Seltzer. 
Bromo-Soda.     (Warner's.) 
Bromo-Tanilid. 


376 


REPOKTS  OF   THE  PRESIDENT  S  HOMES  COMMISSION. 


Bromo  Vichy. 

Bromo  Vin. 

Brook's  Headache  Powder. 

Bro-tanilid. 

Brow-ease. 

Bull's  Headache  Specific 

Caf-Aceton.     (Wyeth's.) 

Caffeine  Compound. 

Campaign  Headache  Tablets. 

Capudine. 

Carey's  Heart  Tonic  Headache  Wafers.i 

Cascara  Bromide  Quinine.     (Hill's.) 

Catarrh  &  Headache  Snuff.  (Mar- 
shall's.) 

Celery-Caffeine.     ( Chelf  s. ) 

Celery  &  Caffeine  Bromide.  (French's.) 

Celery  Fomo. 

Celery  Tea. 

Celery  Vesce. 

Cencura.    For  headache. 

Cephalgine. 

Cephaline. 

Cerralgine. 

Chinese  Headache  Cure. 

Dr.  Clay's  Headache  Powders. 

Clover  Headache  Powders. 

Coffee-no. 

Cold  Capsules.     (Stott's.) 

Cole's  Headache  Cure. 

Cole's  Headache  Powder. 

Coppai's  Headache  Cure. 

Coronet  Headache  Cure.     (Bacon.) 

Courney's  Headache  15  minutes. 

Cran-O-Tone. 

Craemer's  Headache  Powders. 

Crown  Headache  Powder. 

Curalgia. 

Daggett  &  Ramsdeirs  Headache  Pow- 
der. 

Daisy  Headache  Powder. 

Daisy  Headache  Wafer. 

Dale,  Hart  &  Co.'s  Headache  Powder. 

Darling's  Cold  Cure. 

Darlington's  Headache  Powder. 

Davidson's  Headache  Powders. 

Davis's  Headache  Cure. 

De  Kalb's  Anti-Headache  Powders. 

De  Kay's  Headache  Wafers. 

De  Loste's  Headache  Powders. 

Dick's  Laxative  Cold  Cure. 

Dllliard's  Headache  Powder. 

Doris's  Headache  Buttons. 

Dutton  Headache  Powders. 

Duffs  Headache  Specific. 

Eames's  Tonic  Headache  Wafers. 

EbbS  Kolo  Caffeine  Headache  Tablets. 

Eddy's  Headache  Specific. 

Eezee's  Headache  Cure. 

Electric  Headache  Powder. 

Empire  Headache  Wafers. 

Eureka  Headache  Powder. 

Eureka  Headache  Cure. 

Fabra's  Headache  Cure. 

Falling's  Headache  Powder. 

Falck's  One  Minute  Headache  Cure. 

Father  Schubert's  Little  Headache 
Tableta. 


Fisher's  Headache  Capsules. 

Fisher's  Quick  Headache  Cure. 

Five  Minute  Headache  Powder. 

Flag  Salt. 

Flower's  Sure  Headache  Cure. 

Dr.  Foote's  Headache  Powder. 

Fowler's  Magic  Headache  Powder. 

Garfield  Headache  Powders. 

Geneseo  Headache  &  Neuralgia  Rem- 
edy. 

G.  E.  S.  S.  Headache  Tablets. 

Gessler's  Headache  Wafers. 

Getman's  Headache  Powder. 

Gibson's  Instant  Headache  Cure. 

Gipsy  Headache  Wafers. 

Goldsmith's  Headache  Wafers. 

Goll's  Dollar  Headache  Cure. 

Good's  Headache  Cure. 

Gregory's  Headache  Powder. 

Grosser's  Headache  Cure. 

Guarana  Compound. 

Guy's  Headache  Powder. 

Hageman's  Headache  Wafers. 

Haller's  Headache  &  Neuralgia  Cure, 

Haller's  Relief  Headache  Powder. 

Hall's  One-Minute  Headache  Cure. 

Hantz's  Headache  Tablets. 

Harmless  Headache  Powder. 

Dr.  Hart's  Headache  Powder. 

Hartwig's  Headache  Tablets. 

Hawley's  Celery  Headache  Capsules. 

Head-A-Cure. 

Headache  Antidote.     (Edward's.) 

Headache  Chocolates. 

Headache  Konseals. 

Headache  Powders.  (Kellogg  &  Car- 
rier.) 

Headachine. 

Headache  Stop. 

Head-Ease.     (Bethea's  Liquid.) 

Head-Ease.     (Cumming's.) 

Head  -  Ease.  ( Peter  -  Heat  -  Richard- 
son's. ) 

Head-Ease.     ( White's. ) 

Head-Easy.     (Stedman's.) 

Headline. 

Headache  Kolone. 

Headache  Kuro. 

Headoria.     (Pearson's.) 

Hed-ake.     (Preston's.) 

Hedakur.     (Hasson's.) 

Hed-Kure.     (Saenger's.) 

I.  N.  Hegeman  &  Co.,  Headache  Pow- 
der. 

Henry's  (Dr.)  Headache  Powder. 

Hick's  Capudine. 

Hobson's  Headache  Cure. 

Hoffman's  Harmless  Headache  Pow- 
der. 

Hogan's  Headache  Powder. 

Holland's  Headache  &  Neuralgia  Pow- 
der. 

Holloway's  Headache  Powder. 

Howe's  Headache  Cure.     (P.  M.  Co.) 

Hufeland's  Sure  Headache  Cure. 

Hutchln's  Headache  Pills. 

L  C.  R.  Cold  k  Catarrh  Relief. 


EEPOETS   OF   THE  PRESIDENT  S  HOMES   COMMISSION. 


377 


Imperial  Headache  Powder. 

Instant  Headache  Wafers.  (Brown  & 
Hoff.) 

I.  S.  M.  A.  Caffanllld. 

James's  Headache  &  Liver  Pills. 

Dr.  J.  W.  James's  Miniature  Headache 
Powder. 

Japanese  Rapid  Headache  Powder. 

Johnson's  Headache  Powder. 

Johnson's  Utah  Headache  Salt. 

Jones's  Cold  &  Grippe  Cure. 

Joslyn's  Instant  Headache  Tablets. 

Kahle's  Headache  Powder. 

Kali-Caffein.     (Claimed  to  be  a  salt.) 

Kalluorine.    Headache  Powder. 

Kapitol  Headache  Wafers. 

Kef. 

Kelly's  Headache  Cure. 

Kennedy's  Headache  Powder. 

Kennedy's  Headache  Tablets. 

King's  Headache  Tablets. 

Knox-a-Cold  Tablets. 

Knill's  Orange  Headache  Pills. 

Kohler's  Headache  Powders. 

Koladine. 

Kolo-Caffein. 

Kolone.     (Lakln's  Hedake.) 

Koos*  Nervine  Headache  Powder. 

Kopfaline. 

Kramer's  Headache  Capsules. 

Kra-Nol. 

Krause's  Headache  Capsules. 

La  Belle  Headache  Tablets. 

Lake's  Headache  Powder. 

Lamprey's  Headache  Cure. 

Lane's  Headache  Capsules. 

Lantz's  Gold  Coin  Headache  Cure. 

Lawrence's  Headache  Powder. 

Laxacold. 

Laxative  Bromo  Quinine.  (Paris 
Med.  Co.) 

Lemon  Seltzer. 

Lemke's  Headache  Powder. 

Lesage's  Headache  Specific. 

Leslie's  Headache  Prescription. 

Dr.  Little's  Headache  Specific. 

Little  Wonder  Headache  Powder. 

Dr.  Lord's  Headache  Powder. 

Dr.  Lung's  Headache  Powder. 

Magnet  Headache  Cure. 

Marquet's  Headache  Wafers. 

Martin's  Headache  Cure. 

Man's  Headache  Powder. 

McGale's  Headache  Cure. 

McGrath's  Headache  &  Neuralgia  Tab- 
lets. 

Malydor  Injection. 

Megrimine.     ( Whitehall's. ) 

Metzger's  Headache  Tablets. 

Meyer's  Headache  &  Neuralgia  Cure. 

Microtine.     (Lepper's.) 

Migrainin.     (Baker's.) 

Migrainoes.    (Digestine  Co.) 

Migrain  Tablets  for  Headache. 

Migrain  Tablets.     (Squibbs'.) 

Migrane  Tablets. 


Miles's  Anti-Pain  Pills. 

Momad's  Headache  Capsules. 

Moore's  Harmless  Headache  Powder. 

Morgan's  Headache  Wafers. 

Morin's  (Dr.  Ed.)  Headache  Wafers. 

Morrison's  Headache  Cure. 

Moyer's  Headache  Tablets. 

Mueller's  German  Headache  Powder. 

Munyon's  Headache  Remedy. 

Narco  Headache  Remedy. 

Narco  Cold  Tablets. 

Natronilid.     (Peck.) 

Nature's  Headache  Tablets. 

Nervease  Powders. 

Neuralgolyne. 

Neuralgia  Capsules. 

Neuralgine. 

Neuralgyline. 

New  Era  Headache  Cure. 

"  999  "  Headache  Powder. 

Now  or  Never  Headache  Powder.  (H 
M.  Co.) 

Nyal's  Headache  Cure. 

Oa  Oa  Headache  Powder. 

O.  K.  Headache  Cure.  (Houston  Drug 
Co.) 

Olusa  Headache  Powders. 

Omega  Headache  Powders.  (Bab- 
cock's.) 

Orangeine. 

Orien's  Headache  Cure. 

Otto's  "  Such  A  "  Headache  Powder.     • 

Pain  in  Your  Head.     (Cooper's.) 

Pain  King.     (John's.) 

Pain  King.      (Shaker's) 

Pain  Paint.   (Goll's.) 

Pain  Paint.     (Wolcott's.) 

Paragon  Headache  Remedy. 

Parker's  Headache  Powder. 

Pasteur's  Stop  a  Pain  Tablets. 

Peck's  Headache  Powder. 

Peek's  Headache  Powder. 

Peerless  Headache  Powder. 

Perfection  Headache  Wafers. 

Perrine's  Quick  Relief.  Headache 
Powder. 

Perry's  Headache  Powder. 

Perry's  Headache  Wafers. 

Phenalgine. 

Phenine.    Headache  Powder. 

Phenokola.  Headache  Powder.  (B.  & 
SO 

Phenolgin. 

Phenyo-Cafifein. 

Phospho-Caffeine  Compound. 

Piatt's  Headache  Wafers. 

Positivus  Headache  Tablets. 

Poythress  Cold  &  Grippe  Cure. 

Preston's  Hed-Ake  Cure. 

Princess  Headache  Powder. 

Pusheck's  Cold  Tablets. 

Quaker  Headache  Capsules. 

Quick  Cure.     (Dr.  Wood's.) 

Quick  Relief  Headache  Cures. 

Quickstop.     (Mattison's.) 

Ramee's  Sick  Headache  Remedy. 


378 


EEPOKTS   OF   THE  PRESIDENT  S  HOMES  COMMISSION. 


Ramsey's  Headache  Elixir. 
Raphael's  Headache  Wafers. 
Rawleigh's  Quinine  15  Minute  Tablets. 
Red  Dragon  Seltzer. 
Rennard's  Headache  Remedy. 
Requa's  Headache  Powder. 
Rexall  Headache  Pills. 
Rexall  Headache  Powder. 
Rexall  Tablets. 

Richardson's  Headache  Powder. 
Rich's  Headache  Powder. 
Rough  on  Headache  Tablets. 
Royal  Headache  Powder. 
Royal  Headache  Tablets. 
Salvitae  Headache  Tablets. 
Sanderson's  Headache  Cure. 
Sand  Mountain  Headache  Tablets. 
Sanltatis  Headache  Tablets. 
Sano  Headache  Cure. 
Sawyer's  Headache  Powder. 
Schmidt's  Headache  Cure. 
Schrader's  Headache  Powder. 
Shilling's  Bromo  Headache  Tablets. 
Shoop's  20-Minute  Headache  Tablets. 
Shrader's  10-Minute  Headache  Powder. 
Solan's  Headache  Wafers. 
Soda  Caffo  Headache  Tablets. 
So-Doc.  Headache  Cure. 
Spen's  Headache  Tablets. 
Stanton's  Harmless  Headache  Powder. 
Schwalb's  Electric  Headache  Powder. 
S.  &  D.'s  Headache  Salt. 
Severa's  Headache  &  Neuralgia  Wafers. 
S.  &  H.'s  Headache  Salt. 
Shac-Stearn's  Headache  Cure. 
Sherlou's  Headache  Powder. 
Sherman's  Headache  Cure. 
Stark's  Headache  Powder. 
Steam's  Headache  Cure. 
Stewart's  (Dr.)  Headache  Powder. 
Scott's  Cold  &  Grippe  Tablets. 
Sunshine  Headache  Powder. 
Swift's  (Dr.)  Headache  Cure. 
Talbot's  Headache  Wafers. 


Taylor's  Headache  Powder. 
Ten  Thousand  Dollar  Headache  Tab- 
lets. 
Thieman's  Headache  Powders. 
Thurston's  Headache  Powder. 
Tousley's  Catarrh  Powder. 
Truc's  Headache  Tablets. 
Tubb's  Cold  &  Grippe  Tablets. 
Tucker's  Fever  &  Headache  Powder. 
Turkish  Headache  Powder. 
Uncle  Sam's  Kola  Headache  Powder. 
Van  Marter's  Headache  Powder. 
Vegelene  Headache  Tablets. 
Vegeta  Headache  Powder. 
Vick's  "  Kadok  "  Headache  Powder. 
V-0  Headache  Relief. 
Walker's  Headache  Wafers. 
Wall's  (Dr.)  Headache  Powder. 
Ward's  Headache  Powder. 
Watkin's  Headache  Tablets. 
Wayne's  Headache  Powder. 
Webster's  Headache  Powder. 
Weeks'  Break  Up  a  Cold  Tablets. 
Welliug's  Headache  Cure. 
Wheat's  Headache  Powders. 
White  Seal  Headache  Powder. 
White  &  White  Headache  Powder. 
Wing's  Headache  Specific. 
Wischerth  &  Dogler's  Headache  Pow- 
der. 
Wright's  Paragon  Tablets. 
Wolfs  Headache  Cure. 
Wood's  Headache  Tablets. 
Wonder  Cure  Headache  Powders.     ' 
X  L  Headache  Wafers. 
Yager's  Handy  Headache  Tablets. 
Yarnell's  Columbian  Headache  Cure. 
Young's  Headache  Powder. 
Yu  Kan  Headache  Powder. 
Zeman's  Headache  Powders. 
Zogat's  Headache  Powder. 
Zerbst's  Little  Giant  Headache  Remedy. 
Zerze's  Positive  Headache  Cure. 


FEMALE  PILLS. 


[By  Lyman  F.  Kebleb,  M.  D.,  Ph.  D.,  Chief,  Division  of  Drugs,  U.  S.  Department 

of  Agriculture.] 

The  publication  of  advertising  matter  inviting  attention  to  means  whereby 
conception  can  be  prevented  or  abortion  produced  is  specifically  prohibited  by 
law.  Hence  the  manufacturers  of  drug  products  which  are  intended  to  be  used 
for  these  purposes  are  careful  not  to  state  openly  in  their  advertising  literature 
the  purposes  for  which  their  preparations  are  intended.  They  manage,  how- 
ever, to  convey  this  information  in  such  a  way  that  those  who  are  interested 
can  readily  understand.  This  is  effected  largely  through  the  character  of  the 
name  employed  for  the  preparation,  and  through  the  agency  of  more  or  less 
guarded  statements  which  appear  upon  the  label  or  in  the  advertising  literature. 
The  name  of  most  of  these  preparations  are  in  themselves  characteristic.  They 
often  contain  the  names  of  drugs  which  have  come  to  be  more  or  less  widely 
known  as  emmenagogues  or  abortifiacients,  for  example,  "  Pennyroyal  Pills," 
"Tansy  Pills,"  "Cotton-root  Pills."  Others  are  so  worded  as  to  be  equally 
characteristic :  "  Female  Regulating  Pills,"  "  Female  Regulator,"  "  French  Pills," 
**  Female  Pills,"  etc.  Each  of  these  terms  indicate  more  or  less  clearly  the 
purpose  for  which  the  preparation  is  intended.  In  addition  more  or  less 
guarded  statements  appear  in  the  advertising  literature.     These  preparations 


EEPOETS    OF    THE  PRESIDENT'S  HOMES   COMMISSION.  379 

are  rarely  recommended  for  the  purpose  mentioned  above  only,  but  are  in  most 
cases  recommended  for  the  cure  of  about  all  of  the  diseases  to  which  the 
peculiar  female  organism  is  liable.  Among  these  conditions,  "  Suppressed  Men- 
struation "  is  given  especial  prominence.  The  following,  taken  from  the  adver- 
tising literature  of  some  of  the  products  in  question,  are  given  in  illustration . 
"  French  Pills.  Safe  and  Positively  Infallible.  Believes  Painful  and  Sup- 
pressed Menstruation,"  etc.     *     *     ♦ 

Female  Beans,  Lion  Drug  Ck).,  Buffalo. 

Feminina,  Mansfield  Drug  Co.,  Memphis. 

Dr.  Trousseau's  Celebrated  Female  Cure,  Dr.  Trousseau  Chemical  Co., 
New  York. 

Female  Pills,  Arch  Pharmacal  Co.^,  San  Francisco. 

Dr.  Arthur's  Pennyroyal  &  Tansy  Pills,  Palestine  Drug  Co.,  St.  Louis. 

Dr.  Bane's  Female  Pills,  A.  V.  Bane  Medical  Co.,  St.  Joseph,  Mo. 

Dr.  Cheeseman's  Female  Regulating  Pills,  Cheeseman  Medicine  Co.,  New 
York. 

Chichester  Pennyroyal  Pills,  Chichester  Chemical  Co.,  Philadelphia. 

Fiske  Clarke's  Female  Pills,  Williams  Mfg.  Co.,  Cleveland. 

Sir  Clarke's  Female  Pills,  Job  Moses,  150  Nassau  street,  New  York. 

Dr.  Constan's  Female  Pills,  Fred'k  K.  Ingram  &  Co.,  Detroit. 

Dr.  Conte's  Female  Pills,  Dr.  Felix  Conte,  Paris. 

Madam  Dean's  Female  Pills,  United  Medical  Co.,  Lancaster,  Pa. 

De  Koven's  Comp.  Pennyroyal  Pills,  Crescent  Chemical  Co.,  Elmira,  N.  T. 

Dubois'  Female  Pills. 

Du  Choin's  Female  Pills. 

Ducro's  Female  Pills,  Dr.  L.  Ducro,  Paris. 

Duponco's  Golden  Female  Pills. 

Duquoi's  Female  Pills,  Dr.  Du  Quoi,  Paris. 

Duquoin's  Pennyroyal  Pills. 

Golden  Female  Pills. 

Female  Pills,  Hillside  Chemical  Co.,  Newburgh,  N.  Y. 

John  Hooper's  Female  Pills. 

Hooper's  Green  Seal  Female  Pills. 

Job  Moses'  Female  Pills,  10  Spruce  street,  and  150  Nassau  street.  New 
York. 

King's  Tansy  Female  Pills,  King  Medicine  Co.,  Boston. 

La  Franco  Female  Pills,  La  Franco  Medical  Co.,  145  North  Eighth  street, 
Philadelphia. 

La  Rues  French  Tabloids. 

Lane's  Female  Pills,  Allan  Pfeiffer  Chemical  Ch.,  St.  Louis. 

Leslie's  Pennyroyal  Pills,  Arthur  Chemical  Co.,  St.  Louis. 

Lyon's  Tansy  Pills,  Empire  State  Drug  Co.,  Buffalo. 

Mangogo  Female  Pills,  New  York  &  London  Drug  Co.,  New  York. 

Monell's  Female  Pills,  C.  E.  Monell,  New  York. 

Mott's  Pennyroyal  Pills,  Williams  Mfg.  Co.,  Cleveland. 

Olive  Branch  Female  Pills,  Olive  Branch  Remedy  Co.,  South  Bend. 

Piso's  Female  Pills,  The  Piso  Co.,  Warren,  Va. 

Red  Cross  Tansy  Pills,  Norman  Lichty  Mfg.  Co.,  Des  Moines. 

Dr.  Sanderson's  Female  Pills. 

Female  Pills,  S.  B.  Medicine  Mfg.  Co.,  Portland,  Oreg. 

Seguro  Compound,  Seguro  Mfg.  Co.,  531  K  street,  Sacramento. 

Dr.  J.  Simms's  Female  Pills,  J.  H.  Simms,  Wilmington,  Del. 

Steam's  Tansy  Pills,  New  York  &  London  Drug  Co.,  New  York. 

Dr.  St.  Jean's  Female  Pills,  St.  Jean  Medical  Co.,  2004  Lexington  avenue, 
New  York. 

Tansy  Cotton  Root  Female  Pills,  New  York  &  London  Drug  Co.,  New 
York. 

Dr.  Thomas's  Pennyroyal  Pills,  Arthur  Chemical  Co.,  St.  Louis. 

Dr.  Larue's  Female  Regulator. 

Severa's  Female  Regulator,  W.  F.  Severa  Co.,  Cedar  Rapids,  Iowa. 

Watkins'  Female  Remedy,  J.  R.  Watkins  Medical  Co.,  Winona,  Minn. 

French,  Antyseptin  Female  Remedy,  Antyseptin  Co.,  Gouverneur,  N.  Y. 

Magnolia  Blossoms,  Female  Suppositories,  South  Bend  Remedy  Co.,  South 
Bend,  Ind. 

Orange  Blossom  Female  Suppositories,  Dr.  J.  A.  McGill  Co.,  Chicago. 


380  EEPOBTS   OF   THE  PRESIDENT'S   HOMES   COMMISSION. 

Washington,  June  15,  1908, 
Dr.  George  M.  Kober, 

Chairman  Committee  on  Social  Betterment 

of  the  President's  Homes  Commission, 

Dear  Dr.  Kober  :  While  you  verbally  told  me  to  "  take  my  time,"  pressure 
of  official  duty  has  very  much  delayed  formal  reply  to  your  letter,  that  the 
committee  on  social  betterment  of  the  President's  Homes  Commission  is  very 
anxious  to  determine  as  far  as  possible  the  causes  of  juvenile  delinquency, 
wife  desertion,  and  nonsupport,  with  special  reference  to  standards  of  living, 
intemperance,  and  other  faulty  environments,  and  should  be  very  glad  to  re- 
ceive from  me  the  results  of  my  observation  and  experience. 

Since  there  are  many  causes  back  of  every  act  voluntarily  elicited  by  the 
human  will,  it  will  be  difficult  to  enumerate  them  all,  even  though  the  inquiry 
be  limited,  as  you  suggest,  by  special  reference  to  standards  of  living.  Yet 
certain  broad  conditions,  rather  than  causes,  may  be  indicated,  improvement  of 
which  may  be  brought  about  by  the  exercise  of  the  police  powers  of  the  state, 
in  the  interest  of  the  general  good  of  society,  and  consequently  of  the  individual 
also;  for,  as  the  President  has  often  reminded  us,  in  the  long  run  we  are  all 
going  up  or  going  down  together. 

Over  twenty  years'  service  as  a  volunteer  helper  of  the  unfortunate  has,  of 
course,  given  me  some  ideas  relative  to  what  the  state  might  do  to  alleviate 
conditions,  without  destroying  individual  initiative.  First,  I  was  early  im- 
pressed that  homes  in  alleys  foster  vice  and  crime.  Many  citizens  fear  to 
enter  the  alleys  even  in  daylight,  the  alleys  are  away  or  aside  from  the  beaten 
lines  of  travel,  and  their  isolation  and  comparative  privacy  encourage  drunken- 
ness and  vagrancy  and  kindred  evils,  not  only  on  the  part  of  denizens,  but 
on  the  part  of  outsiders  glad  to  avail  themselves  of  the  cover  of  the  alleys 
in  their  licentiousness.  No  more  efficient  work  could  be  performed  for  social 
betterment  in  Washington  than  to  absolutely  abolish  all  human  habitations  in 
alleys.  It  is  a  service  of  such  transcendent  importance  to  the  whole  city  that 
it  would  even  be  worth  while  for  the  whole  city  to  bear  the  burden  of  pur- 
chasing these  alley  properties  and  changing  these  properties  into  interior  parks. 

Rents  in  the  alleys  range  from  $7.50  to  $9  per  month  for  four-room  houses, 
without  water  in  the  house,  though  there  may  be  water  in  the  yard.  The 
renters  are  drivers  receiving  from  $5  to  $7.50  per  week  as  wages,  or  day 
laborers,  receiving  from  $1  to  $1.50  per  day,  or  hod-carriers,  who,  when  members 
of  the  union,  receive  $2.25  per  day,  otherwise  less.  Of  course,  these  work 
people  lose  wet  weather  and  are  subject  to  other  losses  of  time  from  different 
vicissitudes,  such  as  waiting  for  building  material.  Sometimes  the  renter  is  a 
foreigner  who  is  a  skilled  artisan  or  stone  mason,  drawing  $4  per  day,  whose 
earnings  suggest  a  better  environment.  When  his  children  are  brought  into 
court,  charged  with  shooting  crap  or  other  disorderly  conduct,  with  the  com- 
panions made  in  the  alleys,  he  is  brought  to  a  realization  that  the  child  is 
more  than  the  dollar,  and  readily  agrees  to  get  out  of  the  alley  into  a  home 
more  suitable  for  an  aspirant  to  American  citizenship. 

We  have  building  regulations  designed  to  secure  the  proper  amount  of  air 
space  for  sleepers;  yet  several  families  will  sometimes  crowd  into  these  small 
alley  houses,  and  this  is  not  the  limit,  for  a  lodger  at  50  cents  a  week  will  often 
be  accommodated  upon  the  floor  of  the  kitchen  in  addition.  The  family  income 
is  almost  invariably  increased  by  the  laundry  work  done  in  these  overcrowded 
tenements  by  the  women  occupants.  Think  of  them,  therefore,  as  nuclei  for 
the  spread  of  contagion.  These  alley  women  prefer  to  do  laundry  work  at  their 
homes  in  the  alleys,  where  there  is  the  least  constraint  and  the  most  gossip. 

Another  serious  evil  is  the  commingling  of  the  sexes.  Children  beyond  the 
age  of  puberty  are  in  the  same  room,  often  sleeping  in  the  same  bed.  Sad  are 
the  results. 

I  endeavor  in  a  familiar  way  to  make  these  people  appreciate  the  situation. 
In  cases  of  overcrowding,  they  are  reminded  that  they  would  not  quarter  cattle 
in  such  cramped  shelter,  for  fear  of  breeding  fever  in  the  animals,  and  yet 
the  human  is  infinitely  more  valuable.  Where  both  sexes  are  occupying  the 
same  sleeping  room,  the  mother  or  the  father  is  asked  if  she  or  he  would  place 
in  that  room  a  lighted  match  near  a  can  of  gunpowder.  Of  course  not,  and 
they  are  shown  the  greater  danger  from  mingling  the  sexes  thus  when  the 
passions  are  strong  and  there  Is  much  ignorance,  and  they  are  reminded  that 
under  such  conditions  common  decency  becomes  impossible.  It  is  not  unusual 
for  married  couples  to  have  well-grown  children  sleeping  1^  the  same  room 


KEPORTS   OF   THE  PBESIDENT's  HOMES  COMMISSION.  381 

with  them  sometimes  in  the  same  bed.  If  the  poverty  be  great,  such  are  re- 
quired to  use  at  least  cheap  screens  as  an  aid  to  decency.  Sometimes  a  careful 
survey  of  the  joint  income  of  the  members  of  the  family  demonstrates  the 
ability  to  get  additional  room,  or  house  space,  especially  if  expenditures  for 
vicious  indulgences  are  cut  out.  And  it  is  possible  to  get,  even  for  the  rents 
paid  for  alley  houses,  houses  of  similar  size  upon  the  streets  of  certain 
localities. 

The  facts  herein  referred  to  are  brought  out  in  the  court  hearings;  but  I 
early  admonished  the  probation  oflBcers  to  make  tactful  inquiries  along  the 
same  lines  in  their  investigations,  being  careful,  however,  not  to  work  at  these 
people,  but  with  them,  in  an  endeavor  to  awaken  ideals  within  the  reach  of 
the  occupants  of  the  houses  in  these  hives  of  humanity. 

The  home  conditions  animadverted  on  give  rise  to  drunkenness,  breaches  of 
the  peace,  wife  desertion,  and  much  of  the  juvenile  delinquency.  Out  of  the 
habitations  of  the  drunkard  or  the  father  who  does  not  provide  for  those  of 
his  own  household,  go  children  not  with  the  innocence  or  the  buoyancy  of 
childhood,  but  children  suffering  the  cravings  of  hunger  and  familiar  with 
scenes  of  debauchery.  To  satisfy  hunger,  they  must  either  beg  or  steal.  Often, 
too,  these  children  find  in  the  tumult  of  the  street,  where  no  one  nags  them, 
surcease  from  the  bickerings  of  the  home.  The  street  becomes  their  most 
prized  rendezvous,  to  be  preferred  to  the  discipline  of  the  school,  and,  there- 
fore, herein  arises  much  truancy,  and  hence  arises  much  of  the  so-called 
wanderlust,  to  be  preftxed  to  the  quarrelsome  home. 

The  nonsupport  law  is  used  to  remedy  these  evils  as  far  as  practicable.  The 
delinquent  husband  is  made  to  go,  on  Saturday  night,  while  he  has  his  weekly 
wage  in  his  pocket,  to  the  nearest  police  station  and  pay  there  a  stipulated 
amount  to  be  turned  over  through  the  clerk  of  this  court  for  the  support  of 
his  wife  or  children,  or  both.  Either  drunkenness  or  infidelity  is  an  incident 
in  these  nonsupport  cases,  and  so  a  pledge  is  also  exacted  to  refrain  from  the 
use  of  liquor  for  the  space  of  a  year,  and  to  cut  out  entirely  the  illegal  in- 
timacy, a  short  instruction  being  given  upon  the  venereal  diseases  following 
upon  such  wrongful  indulgences. 

During  the  first  year  of  the  operations  of  this  court  $6,050.59  were  thus  dis- 
bursed to  needy  families.  In  the  eleven  months  of  this  fiscal  year  the  amount 
was  $19,235.36,  in  small  sums  weekly,  from  $1.50  up.  There  are  now  236 
families  upon  the  relief  roll  at  the  court  This  has  saved  a  burden  to  the  tax- 
payers, minimized  drunkenness,  and  made  lazy  men  work  to  support  themselves 
and  families.  Some  of  these  men  have  improved  so  in  an  economic  sense  that 
they  have  stated  they  were  glad  to  have  been  brought  into  the  court. 

I  may  add  that  I  wish  you  every  success  in  your  noble  work  for  the  better- 
ment of  conditions  in  the  capital  of  our  country,  which  I  am  proud  to  say  is 
my  own  native  city.  President  Roosevelt  will  ever  be  remembered  as  the 
President  who  sought  to  make  this  city  the  embodiment  of  the  highest  ideals 
of  American  life. 

Sincerely,  yours,  Wm.  H.  Dk  Lacy,  Judge, 


ISf?  AND  REGIONAL  PLANNINdl 

University  of  California 

ilCRKELJEY  4.,  CAUFORMIA 


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